GULTIDA SUPPATKUL Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041192261

License Status

NOT RENEWED

Business

First Name

GULTIDA

Last Name

SUPPATKUL

Business Name

GULTIDA SUPPATKUL

Original Issue Date

10/17/1979

Effective Date

03/22/2010

Expiration Date

05/31/2012

City

TINLEY PARK

State

Zip

60487

County

COOK

Ever Disciplined

LastModifiedDate

07/10/2012