BASSEL ERICSOUSSI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050627

License Status

CANCELLED

Business

Title

First Name

BASSEL

Last Name

ERICSOUSSI

Business Name

BASSEL ERICSOUSSI MD

Original Issue Date

06/24/2006

Effective Date

06/24/2006

Expiration Date

06/23/2009

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/15/2008