KATHERINE A BASCONE - Medical Doctor License in Illinois | # 125020146

KATHERINE A BASCONE

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125020146

License Status

EXPIRED

Business

N

First Name

KATHERINE

Middle

A

Last Name

BASCONE

Business Name

KATHERINE A BASCONE

Original Issue Date

07/16/1986

Effective Date

07/16/1986

Expiration Date

07/01/1989

State

IL

Specialty/Qualifier

Family Practice & OMT

Ever Disciplined

N

LastModifiedDate

09/22/2006