KRISTIN KEGLOVITZ BAKER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002665

License Status

NOT RENEWED

Business

First Name

KRISTIN

Middle

KEGLOVITZ

Last Name

BAKER

Business Name

KRISTIN KEGLOVITZ BAKER

Original Issue Date

11/17/2005

Effective Date

01/22/2020

Expiration Date

03/01/2022

City

CHICAGO

State

Zip

60640

County

COOK

Ever Disciplined

LastModifiedDate

07/27/2022