Ponnamma A Samuel
InactiveIllinois license 041215419
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 041215419
- Status
- Inactive
- First issued
- March 9, 1983
- Expired
- May 31, 2016
- License holder
- Ponnamma A Samuel
- Entity type
- Individual
Classifications
- Registered Professional Nurse (Nursing Board) Nursing
More from the license record
- Current term began
- 03/19/2014
Contact
Gurnee, IL 60031
Lake County