NATALIE HEATHER BAKER DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****15

License Status

NOT RENEWED

Business

Title

DMD

First Name

NATALIE

Middle

HEATHER

Last Name

BAKER

Business Name

NATALIE HEATHER BAKER DMD

Original Issue Date

08/03/2015

Effective Date

08/03/2015

Expiration Date

09/30/2018

City

CHICAGO

State

Zip

60604

County

COOK

Specialty/Qualifier

PHARM DISTRIBUTOR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018