SURENDRA BASTI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

ACTIVE

Business

First Name

SURENDRA

Last Name

BASTI

Suffix

Business Name

SURENDRA BASTI MD

Original Issue Date

09/08/2004

Effective Date

06/15/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/15/2023