TARA LYNN BAUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036125991

License Status

NOT RENEWED

Business

First Name

TARA

Middle

LYNN

Last Name

BAUM

Suffix

Business Name

TARA LYNN BAUM MD

Original Issue Date

06/09/2010

Effective Date

04/12/2017

Expiration Date

09/30/2020

City

GALESBURG

State

Zip

61401

County

KNOX

Ever Disciplined

LastModifiedDate

01/14/2021