SANDY BASTA DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019034738

License Status

ACTIVE

Business

Title

DDS

First Name

SANDY

Last Name

BASTA

Business Name

SANDY BASTA DDS

Original Issue Date

12/15/2023

Effective Date

07/09/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60607

County

COOK

Ever Disciplined

LastModifiedDate

07/09/2024