ALPHONSAMMA KODUVATHRA - Respiratory Care Practitioner License in Illinois | # 194001630

ALPHONSAMMA KODUVATHRA

Business Entity

NOT RENEWED

License Type

Respiratory Care Practitioner

Description

RESPIRATORY CARE PRACTITIONER

License Number

194001630

License Status

NOT RENEWED

Business

N

First Name

ALPHONSAMMA

Last Name

KODUVATHRA

Business Name

ALPHONSAMMA KODUVATHRA

Original Issue Date

03/18/1998

Effective Date

12/30/2021

Expiration Date

10/31/2023

State

IL

Ever Disciplined

N

LastModifiedDate

03/28/2024