LEOPOLDO M BASILICO MD - Medical Doctor License in California | # 33*****83

LEOPOLDO M BASILICO MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****83

License Status

NOT RENEWED

Business

N

Title

MD

First Name

LEOPOLDO

Middle

M

Last Name

BASILICO

Business Name

LEOPOLDO M BASILICO MD

Original Issue Date

08/02/2012

Effective Date

05/25/2021

Expiration Date

07/31/2023

State

CA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

N

LastModifiedDate

11/30/2023