MARK RICHARD BAKER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

ACTIVE

Business

Title

First Name

MARK

Middle

RICHARD

Last Name

BAKER

Business Name

MARK RICHARD BAKER MD

Original Issue Date

03/14/2019

Effective Date

07/03/2023

Expiration Date

07/31/2026

City

QUINCY

State

Zip

62305

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/03/2023