ZACHARY JOHN BASTIAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

ACTIVE

Business

First Name

ZACHARY

Middle

JOHN

Last Name

BASTIAN

Suffix

Business Name

ZACHARY JOHN BASTIAN MD

Original Issue Date

01/04/2018

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2023