BASAVA P ANCHA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125025686

License Status

EXPIRED

Business

First Name

BASAVA

Middle

Last Name

ANCHA

Business Name

BASAVA P ANCHA

Original Issue Date

06/23/1990

Effective Date

06/23/1990

Expiration Date

06/24/1993

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006