JACK SAMUEL BAUM - Medical Doctor License in Illinois | # 125014947

JACK SAMUEL BAUM

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125014947

License Status

EXPIRED

Business

N

First Name

JACK SAMUEL

Last Name

BAUM

Business Name

JACK SAMUEL BAUM

Original Issue Date

08/23/1982

Effective Date

08/23/1982

Expiration Date

07/01/1984

State

IL

Specialty/Qualifier

Urology

Ever Disciplined

N

LastModifiedDate

09/22/2006