KEVIN W BASZIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

ACTIVE

Business

Title

First Name

KEVIN

Middle

Last Name

BASZIS

Business Name

KEVIN W BASZIS MD

Original Issue Date

12/07/2018

Effective Date

07/05/2023

Expiration Date

07/31/2026

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/05/2023