LOPA BASU DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

NOT RENEWED

Business

Title

First Name

LOPA

Last Name

BASU

Business Name

LOPA BASU DO

Original Issue Date

04/12/2012

Effective Date

04/12/2012

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60601

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014