ANDREA M BAZAN - Medical Doctor License in Illinois | # 125031378

ANDREA M BAZAN

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125031378

License Status

EXPIRED

Business

N

First Name

ANDREA M

Last Name

BAZAN

Business Name

ANDREA M BAZAN

Original Issue Date

05/23/1994

Effective Date

05/23/1994

Expiration Date

06/30/1997

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006