GERALD M BAKER Athletics Professional License verification

Business Entity

NOT RENEWED

License Type

Athletics Professional

Description

ATHLETICS - LICENSED PHYSICIAN

License Number

002020018-0002

License Status

NOT RENEWED

Business

First Name

GERALD M

Last Name

BAKER

Business Name

GERALD M BAKER

Original Issue Date

08/16/1980

Effective Date

08/16/1980

Expiration Date

08/16/1981

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

09/18/2006