ERIC A BACA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125021312

License Status

EXPIRED

Business

First Name

ERIC

Middle

Last Name

BACA

Business Name

ERIC A BACA

Original Issue Date

06/13/1987

Effective Date

06/13/1987

Expiration Date

07/01/1990

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/22/2006