KATRINA BAUTISTA ACOSTA MD - Medical Doctor License in Illinois | # 125039795

KATRINA BAUTISTA ACOSTA MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039795

License Status

CANCELLED

Business

N

First Name

KATRINA

Middle

BAUTISTA

Last Name

ACOSTA

Suffix

MD

Business Name

KATRINA BAUTISTA ACOSTA MD

Original Issue Date

07/01/1999

Effective Date

07/01/1999

Expiration Date

06/30/2002

State

IL

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

N

LastModifiedDate

09/22/2006