KATRINA D BAKER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****49

License Status

NOT RENEWED

Business

First Name

KATRINA

Middle

Last Name

BAKER

Business Name

KATRINA D BAKER

Original Issue Date

09/23/2003

Effective Date

09/23/2003

Expiration Date

07/31/2005

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006