WALTEN I BABA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

NOT RENEWED

Business

First Name

WALTEN I

Last Name

BABA

Suffix

Business Name

WALTEN I BABA MD

Original Issue Date

01/01/1997

Effective Date

05/19/2015

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60625

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020