BASANTI MUKERJI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

NOT RENEWED

Business

First Name

BASANTI

Last Name

MUKERJI

Suffix

Business Name

BASANTI MUKERJI MD

Original Issue Date

03/15/1999

Effective Date

06/14/2011

Expiration Date

07/31/2014

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020