BOONCHOM PHUTAWON Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041173747

License Status

NOT RENEWED

Business

First Name

BOONCHOM

Last Name

PHUTAWON

Business Name

BOONCHOM PHUTAWON

Original Issue Date

05/12/1977

Effective Date

04/08/2010

Expiration Date

05/31/2012

City

CHICAGO

State

Zip

60615

County

COOK

Ever Disciplined

LastModifiedDate

07/10/2012