BETH ANN BASOLA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125041435

License Status

EXPIRED

Business

First Name

BETH ANN

Last Name

BASOLA

Suffix

Business Name

BETH ANN BASOLA MD

Original Issue Date

06/16/2000

Effective Date

06/16/2000

Expiration Date

06/15/2001

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006