DANIEL ALEXANDER BAKSTON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060324

License Status

CANCELLED

Business

Title

First Name

DANIEL

Middle

ALEXANDER

Last Name

BAKSTON

Business Name

DANIEL ALEXANDER BAKSTON MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2013

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Preventive Medicine

Ever Disciplined

LastModifiedDate

06/16/2011