BARON VON BAUCOM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

First Name

BARON

Middle

VON

Last Name

BAUCOM

Suffix

Business Name

BARON VON BAUCOM MD

Original Issue Date

01/01/1997

Effective Date

04/25/2011

Expiration Date

07/31/2014

City

CARBONDALE

State

Zip

62901

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014