KATRINA BAUTISTA ACOSTA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039795

License Status

CANCELLED

Business

First Name

KATRINA

Middle

BAUTISTA

Last Name

ACOSTA

Suffix

Business Name

KATRINA BAUTISTA ACOSTA MD

Original Issue Date

07/01/1999

Effective Date

07/01/1999

Expiration Date

06/30/2002

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/22/2006