ELISHA KHOUNTHAVONG
Medical Practice at Clarice St, Grand Prairie, TX

License number
Florida 532501
Issued Date
Sep 2, 2010
Effective Date
Jun 15, 2013
Expiration Date
Dec 1, 2012
Category
Health Care
Type
Emergency Medical Technician
Address
Address 2
1106 Clarice St, Grand Prairie, TX 75051
884 Brunswick Ln, Viera, FL 32955
Phone
(321) 213-6096
LicenseFiles verified this license of Jun 1, 2017 at the Health Care Practitioner Data Portal.

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