RODRIGO BASTIDAS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

NOT RENEWED

Business

First Name

RODRIGO

Last Name

BASTIDAS

Business Name

RODRIGO BASTIDAS

Original Issue Date

01/22/1992

Effective Date

01/22/1992

Expiration Date

07/31/2002

City

ALGONQUIN

State

Zip

60102

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020