JONATHAN BAUTISTA TANAWAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036170234

License Status

ACTIVE

Business

Title

First Name

JONATHAN

Middle

BAUTISTA

Last Name

TANAWAN

Business Name

JONATHAN BAUTISTA TANAWAN MD

Original Issue Date

05/10/2024

Effective Date

05/10/2024

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

05/23/2025