LUCY G BASTA MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036063402

License Status

INACTIVE

Business

First Name

LUCY G

Last Name

BASTA

Suffix

Business Name

LUCY G BASTA MD

Original Issue Date

10/19/1981

Effective Date

10/19/1981

Expiration Date

07/31/1993

City

BURKBURNETT

State

Zip

76354

County

TEXAS

Ever Disciplined

LastModifiedDate

09/20/2006