TIMOTHY KEITH BAKER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047334

License Status

CANCELLED

Business

First Name

TIMOTHY

Middle

KEITH

Last Name

BAKER

Suffix

Business Name

TIMOTHY KEITH BAKER MD

Original Issue Date

06/24/2004

Effective Date

06/24/2004

Expiration Date

06/23/2007

City

CHICAGO

State

Zip

60613

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006