ANNA I BASS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

NOT RENEWED

Business

First Name

ANNA

Middle

Last Name

BASS

Business Name

ANNA I BASS

Original Issue Date

08/13/2001

Effective Date

08/13/2001

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60625

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006