JOSEPH P BAST Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

NOT RENEWED

Business

First Name

JOSEPH

Middle

Last Name

BAST

Business Name

JOSEPH P BAST

Original Issue Date

09/06/2006

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

NAPERVILLE

State

Zip

60563

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011