SOUPHAPHONE BOUNMYTHAVONG NICKSIC Registered Nurse License verification

Business Entity

ACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041390240

License Status

ACTIVE

Business

First Name

SOUPHAPHONE

Middle

BOUNMYTHAVONG

Last Name

NICKSIC

Business Name

SOUPHAPHONE BOUNMYTHAVONG NICKSIC

Original Issue Date

02/04/2011

Effective Date

04/17/2024

Expiration Date

05/31/2026

City

SOUTH ELGIN

State

Zip

60177

County

KANE

Ever Disciplined

LastModifiedDate

02/28/2026