FATHY Z BASILIOS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036073898

License Status

NOT RENEWED

Business

First Name

FATHY Z

Last Name

BASILIOS

Suffix

Business Name

FATHY Z BASILIOS MD

Original Issue Date

10/07/1986

Effective Date

05/15/2017

Expiration Date

09/30/2020

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

01/14/2021