PHOTHONG NACHAMPASSACK - Registered Nurse License in Illinois | # 043104052

PHOTHONG NACHAMPASSACK

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043104052

License Status

NOT RENEWED

Business

N

First Name

PHOTHONG

Last Name

NACHAMPASSACK

Business Name

PHOTHONG NACHAMPASSACK

Original Issue Date

09/05/2007

Effective Date

01/13/2023

Expiration Date

02/28/2025

State

IL

Ever Disciplined

N

LastModifiedDate

05/08/2025