BRANDI NICOLE BASKET DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

NOT RENEWED

Business

Title

First Name

BRANDI

Middle

NICOLE

Last Name

BASKET

Business Name

BRANDI NICOLE BASKET DO

Original Issue Date

06/29/2017

Effective Date

06/29/2017

Expiration Date

09/30/2020

City

HARRISON TOWNSHIP

State

Zip

48045

County

MICHIGAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021