SURENDRA BASTI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112224

License Status

ACTIVE

Business

First Name

SURENDRA

Last Name

BASTI

Suffix

Business Name

SURENDRA BASTI MD

Original Issue Date

08/27/2004

Effective Date

06/15/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

10/14/2023