ANNA I BASS - Medical Doctor License in Illinois | # 036104822

ANNA I BASS

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036104822

License Status

NOT RENEWED

Business

N

First Name

ANNA

Middle

I

Last Name

BASS

Business Name

ANNA I BASS

Original Issue Date

05/24/2001

Effective Date

05/24/2001

Expiration Date

07/31/2005

State

IL

Ever Disciplined

N

LastModifiedDate

10/09/2006