RAY ANTHONY BASA MD Surgical Assistant/Technologist License verification

Business Entity

NOT RENEWED

License Type

Surgical Assistant/Technologist

Description

REGISTERED SURGICAL ASSISTANT

License Number

238000041

License Status

NOT RENEWED

Business

Title

First Name

RAY

Middle

ANTHONY

Last Name

BASA

Business Name

RAY ANTHONY BASA MD

Original Issue Date

10/19/2005

Effective Date

03/07/2016

Expiration Date

04/30/2018

City

EVANSTON

State

Zip

60202

County

COOK

Ever Disciplined

LastModifiedDate

06/19/2018