SUPORN PHEOMTHAWEE - Registered Nurse License in Illinois | # 041225601

SUPORN PHEOMTHAWEE

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041225601

License Status

INACTIVE

Business

N

First Name

SUPORN

Last Name

PHEOMTHAWEE

Business Name

SUPORN PHEOMTHAWEE

Original Issue Date

10/09/1984

Effective Date

10/09/1984

Expiration Date

05/31/2006

City

SKOKIE

State

IL

Zip

60076

County

COOK

Ever Disciplined

N

LastModifiedDate

10/09/2006