CHANSOUK S THAMMARATH Registered Nurse License verification

Business Entity

ACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043081034

License Status

ACTIVE

Business

First Name

CHANSOUK

Middle

Last Name

THAMMARATH

Business Name

CHANSOUK S THAMMARATH

Original Issue Date

07/24/1997

Effective Date

11/01/2024

Expiration Date

01/31/2027

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/01/2024