CHANTHANALY S CHAMPA Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043083688

License Status

NOT RENEWED

Business

First Name

CHANTHANALY

Middle

Last Name

CHAMPA

Business Name

CHANTHANALY S CHAMPA

Original Issue Date

05/07/1999

Effective Date

03/07/2001

Expiration Date

01/31/2001

City

AMARILLO

State

Zip

79107

County

TEXAS

Ever Disciplined

LastModifiedDate

10/21/2005