MANGA DEVI KODALI MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036104409

License Status

INACTIVE

Business

First Name

MANGA

Middle

DEVI

Last Name

KODALI

Suffix

Business Name

MANGA DEVI KODALI MD

Original Issue Date

03/26/2001

Effective Date

03/26/2001

Expiration Date

07/31/2002

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/30/2007