BRISTI BASU Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****89

License Status

ACTIVE

Business

First Name

BRISTI

Last Name

BASU

Business Name

BRISTI BASU

Original Issue Date

01/27/2025

Effective Date

02/05/2026

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60610

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2026