BOTROS A BASSALI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036045151

License Status

NOT RENEWED

Business

First Name

BOTROS A

Last Name

BASSALI

Suffix

Business Name

BOTROS A BASSALI MD

Original Issue Date

02/04/1972

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

WESTERN SPRINGS

State

Zip

60558

County

COOK

Ever Disciplined

LastModifiedDate

11/06/2008