CHARISSE LIZ BASTE TREECE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070987

License Status

EXPIRED

Business

Title

First Name

CHARISSE

Middle

LIZ BASTE

Last Name

TREECE

Business Name

CHARISSE LIZ BASTE TREECE MD

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2021

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

10/11/2022