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Khanxay Souphom

EMT-Intermediatelapsed - failure to renewLicense I037909
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Provider Information

First Name
Khanxay
Last Name
Souphom
License Number
I037909
License Prefix
I
Provider Type
EMT-Intermediate
Status
lapsed - failure to renew
County
Not listed
State
GA
GEMSIS ID
c2b2891b-63aa-e911-8259-cccaa7913d97

Grade

Grade not yet available.

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