TIMOTHY KEITH BAKER MD - Medical Doctor License in Illinois | # 125047334

TIMOTHY KEITH BAKER MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047334

License Status

CANCELLED

Business

N

First Name

TIMOTHY

Middle

KEITH

Last Name

BAKER

Suffix

MD

Business Name

TIMOTHY KEITH BAKER MD

Original Issue Date

06/24/2004

Effective Date

06/24/2004

Expiration Date

06/23/2007

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006