TAMMY C D'SOUZA - Medical Doctor License in Illinois | # 125034092

TAMMY C D'SOUZA

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034092

License Status

EXPIRED

Business

N

First Name

TAMMY

Middle

C

Last Name

D'SOUZA

Business Name

TAMMY C D'SOUZA

Original Issue Date

05/02/1996

Effective Date

05/02/1996

Expiration Date

06/30/1999

State

IL

Specialty/Qualifier

Family Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006