MICHAEL J BAUTISTA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125022212

License Status

EXPIRED

Business

First Name

MICHAEL J

Last Name

BAUTISTA

Suffix

Business Name

MICHAEL J BAUTISTA MD

Original Issue Date

05/11/1988

Effective Date

05/11/1988

Expiration Date

06/30/1992

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

09/22/2006