BASIL L ANDERSON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

NOT RENEWED

Business

First Name

BASIL L

Last Name

ANDERSON

Business Name

BASIL L ANDERSON

Original Issue Date

04/24/1989

Effective Date

04/24/1989

Expiration Date

07/31/1990

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006