ROXANNE J L BAUTISTA-SZORC MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076735

License Status

CANCELLED

Business

Title

First Name

ROXANNE J

Middle

Last Name

BAUTISTA-SZORC

Business Name

ROXANNE J L BAUTISTA-SZORC MD

Original Issue Date

06/26/2020

Effective Date

06/26/2020

Expiration Date

06/25/2023

City

SPRINGFIELD

State

Zip

62701

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/18/2020