BRIAN LEE BAKER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045637

License Status

EXPIRED

Business

First Name

BRIAN

Middle

LEE

Last Name

BAKER

Suffix

Business Name

BRIAN LEE BAKER MD

Original Issue Date

06/24/2003

Effective Date

06/24/2003

Expiration Date

06/23/2007

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

07/03/2007