BASIL L ANDERSON Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125020406

License Status

EXPIRED

Business

First Name

BASIL L

Last Name

ANDERSON

Business Name

BASIL L ANDERSON

Original Issue Date

01/15/1987

Effective Date

01/15/1987

Expiration Date

01/01/1989

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006