MICHAEL J BAUTISTA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****49

License Status

ACTIVE

Business

First Name

MICHAEL J

Last Name

BAUTISTA

Suffix

Business Name

MICHAEL J BAUTISTA MD

Original Issue Date

07/01/1992

Effective Date

07/18/2023

Expiration Date

07/31/2026

City

CLARENDON HILLS

State

Zip

60514

County

DUPAGE

Controlled Substance Schedule

I II III IV V

Ever Disciplined

LastModifiedDate

07/18/2023