DAVID A BALTIERRA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

NOT RENEWED

Business

First Name

DAVID A

Last Name

BALTIERRA

Suffix

Business Name

DAVID A BALTIERRA MD

Original Issue Date

07/22/1996

Effective Date

07/22/1996

Expiration Date

07/31/1999

City

OAK PARK

State

Zip

60302

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006