ERIC MATTHEW BASTA DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019031209

License Status

ACTIVE

Business

Title

DDS

First Name

ERIC

Middle

MATTHEW

Last Name

BASTA

Business Name

ERIC MATTHEW BASTA DDS

Original Issue Date

06/21/2017

Effective Date

05/10/2024

Expiration Date

09/30/2027

City

PALATINE

State

Zip

60074

County

COOK

Ever Disciplined

LastModifiedDate

05/10/2024