RICHARD MARTIN BASS MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****88

NOT RENEWED

N

RICHARD MARTIN

BASS

MD

RICHARD MARTIN BASS MD

01/01/1997

08/03/2020

07/31/2023

SPRINGFIELD

IL

62702

SANGAMON

II III IV V

N

11/30/2023