RICHARD D BASILE JR 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

RICHARD D

Last Name

BASILE JR

Suffix

Business Name

RICHARD D BASILE JR MD

Original Issue Date

05/02/1995

Effective Date

05/02/1995

Expiration Date

07/31/1996

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006