KHAMLA PHOMMACHACK
Nursing at Orangeside Rd, Palm Harbor, FL

License number
Florida 18950
Issued Date
Sep 29, 1993
Effective Date
Jan 21, 2010
Expiration Date
Dec 31, 2007
Category
Health Care
Type
Certified Nursing Assistant
Address
Address 2
2230 Orangeside Rd, Palm Harbor, FL 34683
2770 Regency Oaks Blvd, Clearwater, FL 33759
LicenseFiles verified this license of Jun 1, 2017 at the Health Care Practitioner Data Portal.

Personal information

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Name
Address
Phone
Khamla Phommachack, age 73
2566 Oak St, Clearwater, FL 33764
(727) 507-0342
Khamla Phommachack, age 73
2566 Oak Trl S, Clearwater, FL 33764
(727) 507-0342
Khamla Phommachack, age 73
4011 22Nd Ave N, Saint Petersburg, FL 33713
(727) 321-8102
Khamla Phommachack, age 73
4011 22Nd St, Saint Petersburg, FL 33713
(727) 321-8102

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