JOHN MICHAEL BACA Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****79

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

MICHAEL

Last Name

BACA

Business Name

JOHN MICHAEL BACA

Original Issue Date

10/06/2014

Effective Date

01/08/2015

Expiration Date

01/31/2017

City

DES PLAINES

State

Zip

60016

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/27/2017