QUEENIE M DCOSTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036141700

License Status

NOT RENEWED

Business

Title

First Name

QUEENIE

Middle

Last Name

DCOSTA

Business Name

QUEENIE M DCOSTA MD

Original Issue Date

09/14/2016

Effective Date

07/27/2017

Expiration Date

09/30/2020

City

SOUTHLAKE

State

Zip

76092

Ever Disciplined

LastModifiedDate

01/14/2021