CHAMCHAN VONGKANCOM - Registered Nurse License in Illinois | # 041157799

CHAMCHAN VONGKANCOM

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041157799

License Status

NOT RENEWED

Business

N

First Name

CHAMCHAN

Last Name

VONGKANCOM

Business Name

CHAMCHAN VONGKANCOM

Original Issue Date

09/11/1974

Effective Date

06/01/2018

Expiration Date

09/30/2020

State

IL

Ever Disciplined

N

LastModifiedDate

01/14/2021