KONSTANTIN V MAKHATADZE
Nursing at Riv Ave, Canaan Lake, NY

License number
Florida 5145424
Issued Date
Dec 20, 1999
Effective Date
Aug 19, 2011
Expiration Date
Jul 31, 2009
Category
Health Care
Type
Licensed Practical Nurse
Address
Address
250 River Ave APT 126, Canaan Lake, NY 11772
Phone
(631) 569-2853
LicenseFiles verified this license of Jun 1, 2017 at the Health Care Practitioner Data Portal.

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