NENITA S PRIETO-BASA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036046576

License Status

NOT RENEWED

Business

First Name

NENITA S

Last Name

PRIETO-BASA

Suffix

Business Name

NENITA S PRIETO-BASA MD

Original Issue Date

10/19/1972

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

COLLINSVILLE

State

Zip

62234

County

MADISON

Ever Disciplined

LastModifiedDate

11/06/2008