BASSEL ERICSOUSSI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

ACTIVE

Business

Title

First Name

BASSEL

Last Name

ERICSOUSSI

Business Name

BASSEL ERICSOUSSI MD

Original Issue Date

11/05/2008

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60607

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023