LOPA BASU DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036130060

License Status

NOT RENEWED

Business

Title

First Name

LOPA

Last Name

BASU

Business Name

LOPA BASU DO

Original Issue Date

04/12/2012

Effective Date

04/12/2012

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60601

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014