BRANDON BAUTISTA DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125083873

License Status

ACTIVE

Business

Title

First Name

BRANDON

Last Name

BAUTISTA

Business Name

BRANDON BAUTISTA DO

Original Issue Date

07/01/2024

Effective Date

07/01/2024

Expiration Date

06/30/2027

City

CHICAGO

State

Zip

60657

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/08/2024