PHETDARAPHONE XAYACHANLA Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043100784

License Status

NOT RENEWED

Business

First Name

PHETDARAPHONE

Last Name

XAYACHANLA

Business Name

PHETDARAPHONE XAYACHANLA

Original Issue Date

11/03/2005

Effective Date

11/03/2005

Expiration Date

01/31/2007

City

ELGIN

State

Zip

60120

County

KANE

Ever Disciplined

LastModifiedDate

03/16/2007