JACK SAMUEL BAUM Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125014947

License Status

EXPIRED

Business

First Name

JACK SAMUEL

Last Name

BAUM

Business Name

JACK SAMUEL BAUM

Original Issue Date

08/23/1982

Effective Date

08/23/1982

Expiration Date

07/01/1984

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Urology

Ever Disciplined

LastModifiedDate

09/22/2006