GASTON CARLOS BASLET MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039858

License Status

CANCELLED

Business

First Name

GASTON

Middle

CARLOS

Last Name

BASLET

Suffix

Business Name

GASTON CARLOS BASLET MD

Original Issue Date

07/01/1999

Effective Date

07/01/1999

Expiration Date

06/30/2002

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

07/12/2007