HEIDI J BACA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125025008

License Status

EXPIRED

Business

First Name

HEIDI J

Last Name

BACA

Business Name

HEIDI J BACA

Original Issue Date

05/23/1990

Effective Date

05/23/1990

Expiration Date

06/30/1994

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

09/22/2006