OUEDRAEGO BASGA BERNARD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

NOT RENEWED

Business

First Name

OUEDRAEGO BASGA

Last Name

BERNARD

Suffix

Business Name

OUEDRAEGO BASGA BERNARD MD

Original Issue Date

01/01/1997

Effective Date

05/10/2017

Expiration Date

09/30/2020

City

BELLEVILLE

State

Zip

62223

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021