TARA LYNN BAUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

First Name

TARA

Middle

LYNN

Last Name

BAUM

Suffix

Business Name

TARA LYNN BAUM MD

Original Issue Date

06/11/2010

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

GALESBURG

State

Zip

61401

County

KNOX

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021