KATHY K BAK Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045315

License Status

EXPIRED

Business

First Name

KATHY

Middle

Last Name

BAK

Business Name

KATHY K BAK

Original Issue Date

07/05/2002

Effective Date

07/05/2002

Expiration Date

07/04/2005

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006