RYAN PAUL BASHAM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054496

License Status

EXPIRED

Business

Title

First Name

RYAN

Middle

PAUL

Last Name

BASHAM

Business Name

RYAN PAUL BASHAM MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2012

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

08/29/2012