PRAVESH M S BASNET MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057063

License Status

CANCELLED

Business

Title

First Name

PRAVESH

Middle

M S

Last Name

BASNET

Business Name

PRAVESH M S BASNET MD

Original Issue Date

06/26/2009

Effective Date

06/26/2009

Expiration Date

06/25/2012

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

06/01/2009