BASHAR ERICSOOSSI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****67

License Status

NOT RENEWED

Business

First Name

BASHAR

Last Name

ERICSOOSSI

Suffix

Business Name

BASHAR ERICSOOSSI MD

Original Issue Date

06/22/2011

Effective Date

05/27/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60607

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017