SURENDRA BASTI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039779

License Status

EXPIRED

Business

First Name

SURENDRA

Last Name

BASTI

Suffix

Business Name

SURENDRA BASTI MD

Original Issue Date

06/24/1999

Effective Date

06/24/1999

Expiration Date

07/31/2003

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

09/22/2006