NANCY E BASS Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125024834

License Status

EXPIRED

Business

First Name

NANCY

Middle

Last Name

BASS

Business Name

NANCY E BASS

Original Issue Date

05/17/1990

Effective Date

05/17/1990

Expiration Date

06/30/1993

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006