JENNIFER MARIE D'SOUZA DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

Title

First Name

JENNIFER

Middle

MARIE

Last Name

D'SOUZA

Business Name

JENNIFER MARIE D'SOUZA DO

Original Issue Date

11/08/2012

Effective Date

07/14/2014

Expiration Date

07/31/2017

City

MOUNT PROSPECT

State

Zip

60056

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017