ELIZABETH D BASHAM MD - Medical Doctor License in Illinois | # 125054745

ELIZABETH D BASHAM MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054745

License Status

EXPIRED

Business

N

Title

MD

First Name

ELIZABETH

Middle

D

Last Name

BASHAM

Business Name

ELIZABETH D BASHAM MD

Original Issue Date

06/23/2011

Effective Date

06/23/2011

Expiration Date

06/22/2012

State

IL

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

N

LastModifiedDate

08/29/2012