TAMMY C D'SOUZA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

NOT RENEWED

Business

First Name

TAMMY

Middle

Last Name

D'SOUZA

Business Name

TAMMY C D'SOUZA

Original Issue Date

09/17/1999

Effective Date

09/17/1999

Expiration Date

07/31/2002

City

SPRINGFIELD

State

Zip

62781

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006