GUSTAVO A SOSA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

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

62794

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014