JOSEPH P BAST Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047348

License Status

EXPIRED

Business

First Name

JOSEPH

Middle

Last Name

BAST

Business Name

JOSEPH P BAST

Original Issue Date

06/22/2004

Effective Date

06/22/2004

Expiration Date

06/21/2007

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/03/2007