NOUPHONE S PRATHOUMMACHITH Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043065054

License Status

NOT RENEWED

Business

First Name

NOUPHONE S

Last Name

PRATHOUMMACHITH

Business Name

NOUPHONE S PRATHOUMMACHITH

Original Issue Date

12/15/1987

Effective Date

01/12/2009

Expiration Date

01/31/2011

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

03/10/2011