ANTHONY BARTHOLOMEW D'SOUZA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

NOT RENEWED

Business

Title

First Name

ANTHONY

Middle

BARTHOLOMEW

Last Name

D'SOUZA

Business Name

ANTHONY BARTHOLOMEW D'SOUZA MD

Original Issue Date

03/24/1982

Effective Date

06/24/2020

Expiration Date

07/31/2023

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023