TAMMY C D'SOUZA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034092

License Status

EXPIRED

Business

First Name

TAMMY

Middle

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

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006