Mariam Zachariah Koduvalil
InactiveIllinois license 041209542
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 041209542
- Status
- Inactive
- First issued
- May 10, 1982
- Expired
- August 31, 2022
- License holder
- Mariam Zachariah Koduvalil
- Entity type
- Individual
Classifications
- Registered Professional Nurse (Nursing Board) Nursing
More from the license record
- Current term began
- 09/01/2020
Contact
Mount Vernon, IL 62864
Jefferson County