BASMA AL-BAST MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

ACTIVE

Business

Title

First Name

BASMA

Last Name

AL-BAST

Business Name

BASMA AL-BAST MD

Original Issue Date

01/15/2021

Effective Date

04/09/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62781

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/09/2023