MANGA DEVI KODALI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125038069

License Status

EXPIRED

Business

First Name

MANGA

Middle

DEVI

Last Name

KODALI

Suffix

Business Name

MANGA DEVI KODALI MD

Original Issue Date

05/28/1998

Effective Date

05/28/1998

Expiration Date

06/25/2001

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006