KATHY K BAK - Medical Doctor License in Illinois | # 125045315

KATHY K BAK

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045315

License Status

EXPIRED

Business

N

First Name

KATHY

Middle

K

Last Name

BAK

Business Name

KATHY K BAK

Original Issue Date

07/05/2002

Effective Date

07/05/2002

Expiration Date

07/04/2005

State

IL

Specialty/Qualifier

Family Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006