GEOANNA MARIE S BAUTISTA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067243

License Status

EXPIRED

Business

First Name

GEOANNA MARIE

Middle

Last Name

BAUTISTA

Suffix

Business Name

GEOANNA MARIE S BAUTISTA MD

Original Issue Date

06/22/2015

Effective Date

06/22/2015

Expiration Date

06/21/2018

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

10/25/2018