NATHANIEL JAMES BAKER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074238

License Status

CANCELLED

Business

Title

First Name

NATHANIEL

Middle

JAMES

Last Name

BAKER

Business Name

NATHANIEL JAMES BAKER MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

05/22/2019