ERIC BASAPPA MD - Medical Doctor License in Illinois | # 125076165

ERIC BASAPPA MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076165

License Status

CANCELLED

Business

N

Title

MD

First Name

ERIC

Last Name

BASAPPA

Business Name

ERIC BASAPPA MD

Original Issue Date

07/01/2023

Effective Date

07/01/2023

Expiration Date

06/30/2024

State

IL

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

N

LastModifiedDate

05/23/2023