DOMINIQUE CAROL D'SOUZA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

ACTIVE

Business

Title

First Name

DOMINIQUE

Middle

CAROL

Last Name

D'SOUZA

Business Name

DOMINIQUE CAROL D'SOUZA MD

Original Issue Date

05/06/2024

Effective Date

05/06/2024

Expiration Date

07/31/2026

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/06/2024