KHANKHAM PHOMMAVONG - Registered Nurse License in Illinois | # 041393221

KHANKHAM PHOMMAVONG

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041393221

License Status

INACTIVE

Business

N

First Name

KHANKHAM

Last Name

PHOMMAVONG

Business Name

KHANKHAM PHOMMAVONG

Original Issue Date

06/28/2011

Effective Date

03/13/2018

Expiration Date

09/30/2020

State

IL

Ever Disciplined

N

LastModifiedDate

03/08/2020