MARIO BAUTISTA SY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036108735

License Status

ACTIVE

Business

First Name

MARIO

Middle

BAUTISTA

Last Name

Suffix

Business Name

MARIO BAUTISTA SY MD

Original Issue Date

03/10/2003

Effective Date

10/05/2023

Expiration Date

07/31/2026

City

BETTENDORF

State

Zip

52722

Ever Disciplined

LastModifiedDate

10/05/2023