Asunta Tiburtius Moduthagam
ActiveMichigan license EMC0002656
License
- Licensed by
- Michigan Department of Licensing and Regulatory Affairs
- License number
- EMC0002656
- Status
- Active
- First issued
- November 10, 2022
- Expires
- November 10, 2028
- License holder
- Asunta Tiburtius Moduthagam
- Entity type
- Individual
Classifications
- Expedited Compact (Health) Other Health Care
Contact
31 Neri Drive
Schaumburg, IL 90194
Schaumburg, IL 90194