DANIELLE ERICA BASS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050953

License Status

EXPIRED

Business

First Name

DANIELLE

Middle

ERICA

Last Name

BASS

Suffix

Business Name

DANIELLE ERICA BASS MD

Original Issue Date

06/19/2006

Effective Date

06/19/2006

Expiration Date

06/18/2009

City

SKOKIE

State

Zip

60076

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/15/2009