ERNA D BAUTINA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

NOT RENEWED

Business

First Name

ERNA D

Last Name

BAUTINA

Suffix

Business Name

ERNA D BAUTINA MD

Original Issue Date

07/17/1995

Effective Date

07/17/1995

Expiration Date

07/31/1999

City

ST PETER

State

Zip

62880

County

FAYETTE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006