SUPARNA BASU MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

ACTIVE

Business

Title

First Name

SUPARNA

Last Name

BASU

Business Name

SUPARNA BASU MD

Original Issue Date

09/24/2018

Effective Date

05/18/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60640

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/18/2023