SAMIR BASATA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

NOT RENEWED

Business

First Name

SAMIR

Last Name

BASATA

Suffix

Business Name

SAMIR BASATA MD

Original Issue Date

06/16/1982

Effective Date

06/16/1982

Expiration Date

07/31/1993

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006