ELEANOR V BAUTISTA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125031889

License Status

EXPIRED

Business

First Name

ELEANOR V

Last Name

BAUTISTA

Business Name

ELEANOR V BAUTISTA

Original Issue Date

06/20/1994

Effective Date

06/20/1994

Expiration Date

06/23/1997

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006