BASIL L ANDERSON - Medical Doctor License in Illinois | # 125020406

BASIL L ANDERSON

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125020406

License Status

EXPIRED

Business

N

First Name

BASIL L

Last Name

ANDERSON

Business Name

BASIL L ANDERSON

Original Issue Date

01/15/1987

Effective Date

01/15/1987

Expiration Date

01/01/1989

State

IL

Specialty/Qualifier

Family Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006