Utah
Division of Occupational and Professional Licensing
SOUTSADA NIKKI KONESAVANH
Physician Assistant - Physician Assistant
License number
7138480-1206
Date granted
10/02/2008
Date expires
05/31/2016
Class
Physician Assistant - Physician Assistant
Status
Active
Address
WEST JORDAN, UT 84081
utahlicensing.org
ID 29953953
LAST UPDATED 2024-03-07 09:51:28 UTC
LAST UPDATED 2024-03-07 09:51:28 UTC
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