GUSTAVO A SOSA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036128503

License Status

NOT RENEWED

Business

Title

First Name

GUSTAVO

Middle

Last Name

SOSA

Business Name

GUSTAVO A SOSA MD

Original Issue Date

07/14/2011

Effective Date

07/14/2011

Expiration Date

07/31/2014

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

11/17/2014