SAMUEL T BAZ MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036049392

License Status

INACTIVE

Business

First Name

SAMUEL T

Last Name

BAZ

Suffix

Business Name

SAMUEL T BAZ MD

Original Issue Date

08/28/1974

Effective Date

04/22/2014

Expiration Date

07/31/2017

City

WENONA

State

Zip

61377

County

MARSHALL

Ever Disciplined

LastModifiedDate

04/11/2017