SUPA SUTHISRIPOK Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041175382

License Status

INACTIVE

Business

First Name

SUPA

Last Name

SUTHISRIPOK

Business Name

SUPA SUTHISRIPOK

Original Issue Date

10/12/1977

Effective Date

10/12/1977

Expiration Date

05/31/1984

City

WILDWOOD

State

Zip

60030

County

LAKE

Ever Disciplined

LastModifiedDate

09/27/2006