AMY ANTONIA SOUSSAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036151390

License Status

NOT RENEWED

Business

Title

First Name

AMY

Middle

ANTONIA

Last Name

SOUSSAN

Business Name

AMY ANTONIA SOUSSAN MD

Original Issue Date

12/18/2019

Effective Date

06/23/2020

Expiration Date

07/31/2023

City

APO

State

Zip

09114

Ever Disciplined

LastModifiedDate

11/30/2023