DANIEL ALEXANDER BAKSTON MD - Medical Doctor License in Illinois | # 125060324

DANIEL ALEXANDER BAKSTON MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060324

License Status

CANCELLED

Business

N

Title

MD

First Name

DANIEL

Middle

ALEXANDER

Last Name

BAKSTON

Business Name

DANIEL ALEXANDER BAKSTON MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2013

State

IL

Specialty/Qualifier

Preventive Medicine

Ever Disciplined

N

LastModifiedDate

06/16/2011