GAYATRI KOLLURU BAKER DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067194

License Status

EXPIRED

Business

Title

First Name

GAYATRI

Middle

KOLLURU

Last Name

BAKER

Business Name

GAYATRI KOLLURU BAKER DO

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2018

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

10/25/2018