Sergio Gomes De Souza

Name

Sergio Gomes De Souza

Year of birth

1976

Source

USA - Health and Human Services List of Excluded Individuals and Entities

Aliases

Sergio Gomes De Souza

Privacy Request

Additional Information

General: IND- LIC HC SERV PRO

Specialty: DENTIST

Medical license number: 1952778532

Address: 26818 N 65TH DRIVE

City: PHOENIX

State: AZ

Zip code: 85083

Exclusion type: License revocation, suspension, or surrender. Minimum Period: Period imposed by the state licensing authority. (Social Security Act: 1128(b)(4), 42 USC §: 1320a-7(b)(4))

Exclusion date: 2024-11-20


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