MICHAEL JOHN BAX MD - Medical Doctor License in Illinois | # 125059832

MICHAEL JOHN BAX MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059832

License Status

EXPIRED

Business

N

Title

MD

First Name

MICHAEL

Middle

JOHN

Last Name

BAX

Business Name

MICHAEL JOHN BAX MD

Original Issue Date

06/13/2011

Effective Date

06/13/2011

Expiration Date

06/12/2012

State

IL

Specialty/Qualifier

Transitional Year

Ever Disciplined

N

LastModifiedDate

08/29/2012