LORETTA ANNE BAUSTIAN DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036062

License Status

EXPIRED

Business

First Name

LORETTA

Middle

ANNE

Last Name

BAUSTIAN

Suffix

Business Name

LORETTA ANNE BAUSTIAN DO

Original Issue Date

05/14/1997

Effective Date

05/14/1997

Expiration Date

06/23/2000

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006