Phongpan Tana
ExpiredCalifornia license 245723
License
- Licensed by
- California Board of Registered Nursing
- License number
- 245723
- Status
- Expired (Delinquent)
- First issued
- January 1, 1974
- Expired
- October 31, 2017
- License holder
- Phongpan Tana
- Entity type
- Individual
Classifications
- Registered Nurse Nursing
More from the license record
- License type code
- 4001
Contact
19082 Fowler Ave
Cowan Heights, CA 92705
Cowan Heights, CA 92705
Orange County