BARON VON BAUCOM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036061523

License Status

NOT RENEWED

Business

First Name

BARON

Middle

VON

Last Name

BAUCOM

Suffix

Business Name

BARON VON BAUCOM MD

Original Issue Date

02/03/1981

Effective Date

04/25/2011

Expiration Date

07/31/2014

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

12/11/2015

Case Number

1995005431

Action

Probation

Discipline Start Date

03/13/1998

Discipline End Date

06/23/2000