BRADLEY K BAKER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

NOT RENEWED

Business

First Name

BRADLEY K

Last Name

BAKER

Business Name

BRADLEY K BAKER

Original Issue Date

08/01/1991

Effective Date

08/01/1991

Expiration Date

07/31/1999

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020