FATHY Z BASILIOS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

NOT RENEWED

Business

First Name

FATHY Z

Last Name

BASILIOS

Suffix

Business Name

FATHY Z BASILIOS MD

Original Issue Date

06/08/1987

Effective Date

05/15/2017

Expiration Date

09/30/2020

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021