SAMIR BASATA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036064335

License Status

NOT RENEWED

Business

First Name

SAMIR

Last Name

BASATA

Suffix

Business Name

SAMIR BASATA MD

Original Issue Date

05/24/1982

Effective Date

05/24/1982

Expiration Date

07/31/1993

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Ever Disciplined

LastModifiedDate

02/27/2012