Soutsada Nikki Konesavanh
Physician Assistant in Taylorsville, UT

License number
Utah 7138480-8906
Issued Date
Oct 2, 2008
Expiration Date
May 31, 2018
Category
Physician Assistant
Type
Physician Assistant CS (Schedule 2-5)
Address
Address
Taylorsville, UT
Education
UNIVERSITY OF UTAH
LicenseFiles verified this license of Dec 8, 2016 at the Utah Division of Occupational and Professional Licensing.

Personal information

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Name
Address
Phone
Soutsada Konesavanh, age 46
5723 W 6635 S, West Jordan, UT 84081

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