ERIC BASAPPA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076165

License Status

CANCELLED

Business

Title

First Name

ERIC

Last Name

BASAPPA

Business Name

ERIC BASAPPA MD

Original Issue Date

07/01/2023

Effective Date

07/01/2023

Expiration Date

06/30/2024

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

05/23/2023