ELISEO M BAUTISTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036044279

License Status

NOT RENEWED

Business

First Name

ELISEO M

Last Name

BAUTISTA

Suffix

Business Name

ELISEO M BAUTISTA MD

Original Issue Date

06/22/1971

Effective Date

06/22/1971

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Ever Disciplined

LastModifiedDate

09/20/2006