ELLEN PRISCILLA SAQUETON BAUTISTA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052040

License Status

EXPIRED

Business

First Name

ELLEN PRISCILLA

Middle

SAQUETON

Last Name

BAUTISTA

Suffix

Business Name

ELLEN PRISCILLA SAQUETON BAUTISTA MD

Original Issue Date

07/01/2006

Effective Date

07/01/2006

Expiration Date

06/30/2009

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/15/2009