ANDREA BAZAN MD SC Medical Corporation License verification

Business Entity

NOT RENEWED

License Type

Medical Corporation

Description

REGISTERED MEDICAL CORPORATION

License Number

042619109

License Status

NOT RENEWED

Business

Business Name

ANDREA BAZAN MD SC

Original Issue Date

07/25/2007

Effective Date

08/03/2017

Expiration Date

01/01/2018

City

CHICAGO

State

Zip

60616

County

COOK

Ever Disciplined

LastModifiedDate

04/10/2018