MANUEL F BAUTISTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

NOT RENEWED

Business

First Name

MANUEL F

Last Name

BAUTISTA

Suffix

Business Name

MANUEL F BAUTISTA MD

Original Issue Date

01/13/1989

Effective Date

01/13/1989

Expiration Date

07/31/1990

City

DECATUR

State

Zip

62521

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006