BENEDICT D SOUZA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

NOT RENEWED

Business

First Name

BENEDICT

Last Name

D SOUZA

Suffix

Business Name

BENEDICT D SOUZA MD

Original Issue Date

10/12/1982

Effective Date

10/12/1982

Expiration Date

07/31/2002

City

MARYVILLE

State

Zip

62062

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006