SAMANG PONGKLUB Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041172180

License Status

INACTIVE

Business

First Name

SAMANG

Last Name

PONGKLUB

Business Name

SAMANG PONGKLUB

Original Issue Date

12/10/1976

Effective Date

12/10/1976

Expiration Date

05/31/2004

City

WESTMONT

State

Zip

60559

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/09/2006