DOUGLAS K BASSO - Podiatrist License in Illinois | # 135000901

DOUGLAS K BASSO

Business Entity

CANCELLED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000901

License Status

CANCELLED

Business

N

First Name

DOUGLAS

Middle

K

Last Name

BASSO

Business Name

DOUGLAS K BASSO

Original Issue Date

08/17/2015

Effective Date

07/01/2015

Expiration Date

07/01/2018

State

IL

Ever Disciplined

N

LastModifiedDate

05/27/2016