MARK PHILIP BAINBRIDGE DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

NOT RENEWED

Business

First Name

MARK

Middle

PHILIP

Last Name

BAINBRIDGE

Suffix

Business Name

MARK PHILIP BAINBRIDGE DO

Original Issue Date

06/11/2009

Effective Date

06/03/2014

Expiration Date

07/31/2017

City

GALENA

State

Zip

61036

County

JO DAVIESS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017