ANNA I BASS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036104822

License Status

NOT RENEWED

Business

First Name

ANNA

Middle

Last Name

BASS

Business Name

ANNA I BASS

Original Issue Date

05/24/2001

Effective Date

05/24/2001

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60625

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006