STEPHEN DOUGLAS BAST - Physician Assistant License in Illinois | # 085000207

STEPHEN DOUGLAS BAST

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000207

License Status

NOT RENEWED

Business

N

First Name

STEPHEN DOUGLAS

Last Name

BAST

Business Name

STEPHEN DOUGLAS BAST

Original Issue Date

08/20/1980

Effective Date

08/20/1980

Expiration Date

08/20/1984

State

IL

Ever Disciplined

N

LastModifiedDate

03/06/2015