RICHARD MARTIN BASS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036042867

License Status

NOT RENEWED

Business

First Name

RICHARD MARTIN

Last Name

BASS

Suffix

Business Name

RICHARD MARTIN BASS MD

Original Issue Date

09/16/1969

Effective Date

08/03/2020

Expiration Date

07/31/2023

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

11/30/2023