NENITA S PRIETO-BASA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

NOT RENEWED

Business

First Name

NENITA S

Last Name

PRIETO-BASA

Suffix

Business Name

NENITA S PRIETO-BASA MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2008

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008