CHARLES M BASS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036069467

License Status

NOT RENEWED

Business

First Name

CHARLES M

Last Name

BASS

Suffix

Business Name

CHARLES M BASS MD

Original Issue Date

09/18/1984

Effective Date

09/18/1984

Expiration Date

07/31/1987

City

MORTON GROVE

State

Zip

60053

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006