BASHARATH ALI KHAN DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076415

License Status

CANCELLED

Business

Title

First Name

BASHARATH

Middle

ALI

Last Name

KHAN

Business Name

BASHARATH ALI KHAN DO

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2023

City

CHICAGO

State

Zip

60625

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/04/2020