GISELLE ADRIANA BAQUERO CARANAMA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

NOT RENEWED

Business

Title

First Name

GISELLE

Middle

ADRIANA

Last Name

BAQUERO CARANAMA

Business Name

GISELLE ADRIANA BAQUERO CARANAMA MD

Original Issue Date

07/07/2017

Effective Date

12/03/2020

Expiration Date

07/31/2023

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023