ANEETAM BASSI Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****54

License Status

ACTIVE

Business

First Name

ANEETAM

Last Name

BASSI

Business Name

ANEETAM BASSI

Original Issue Date

11/15/2018

Effective Date

10/01/2024

Expiration Date

09/30/2027

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/21/2024