SAMEER BIPIN BAVISHI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125043908

License Status

CANCELLED

Business

First Name

SAMEER

Middle

BIPIN

Last Name

BAVISHI

Suffix

Business Name

SAMEER BIPIN BAVISHI MD

Original Issue Date

07/01/2002

Effective Date

07/01/2002

Expiration Date

06/30/2007

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

06/13/2007