BETH A BAISDEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

NOT RENEWED

Business

First Name

BETH A

Last Name

BAISDEN

Suffix

Business Name

BETH A BAISDEN MD

Original Issue Date

01/16/2018

Effective Date

01/16/2018

Expiration Date

09/30/2020

City

DAYTON

State

Zip

45458

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021