KOSOOM BOONTUKSA Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041138447

License Status

INACTIVE

Business

First Name

KOSOOM

Last Name

BOONTUKSA

Business Name

KOSOOM BOONTUKSA

Original Issue Date

12/17/1970

Effective Date

12/17/1970

Expiration Date

05/01/1982

City

JERSEY CITY

State

Zip

07307

County

NEW JERSEY

Ever Disciplined

LastModifiedDate

09/27/2006