MARK DENISON BALDWIN DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036072803

License Status

NOT RENEWED

Business

Title

First Name

MARK

Middle

DENISON

Last Name

BALDWIN

Business Name

MARK DENISON BALDWIN DO

Original Issue Date

06/04/1986

Effective Date

06/04/1986

Expiration Date

07/31/1999

City

FORT SMITH

State

Zip

72903

Ever Disciplined

LastModifiedDate

09/11/2015

Case Number

1996002488

Action

Suspension

Discipline Start Date

10/11/1996

Discipline End Date

10/06/1998

Discipline Reason

Owed outstanding tax liability for tax Years 1989 through 1992.