KEITH MICHAEL D'SOUZA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036120265

License Status

NOT RENEWED

Business

First Name

KEITH

Middle

MICHAEL

Last Name

D'SOUZA

Suffix

Business Name

KEITH MICHAEL D'SOUZA MD

Original Issue Date

03/05/2008

Effective Date

04/12/2011

Expiration Date

07/31/2014

City

ST LOUIS

State

Zip

63103

County

MISSOURI

Ever Disciplined

LastModifiedDate

11/17/2014