LORETTA ANNE BAUSTIAN DO - Medical Doctor License in Illinois | # 125036062

LORETTA ANNE BAUSTIAN DO

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036062

License Status

EXPIRED

Business

N

First Name

LORETTA

Middle

ANNE

Last Name

BAUSTIAN

Suffix

DO

Business Name

LORETTA ANNE BAUSTIAN DO

Original Issue Date

05/14/1997

Effective Date

05/14/1997

Expiration Date

06/23/2000

State

IL

Specialty/Qualifier

Pediatrics

Ever Disciplined

N

LastModifiedDate

09/22/2006