MICHAEL WALTER BALDAUF MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

Title

First Name

MICHAEL

Middle

WALTER

Last Name

BALDAUF

Business Name

MICHAEL WALTER BALDAUF MD

Original Issue Date

02/28/2019

Effective Date

02/28/2019

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61605

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021