TEOFILO SANTOS BAUTISTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

First Name

TEOFILO SANTOS

Last Name

BAUTISTA

Suffix

Business Name

TEOFILO SANTOS BAUTISTA MD

Original Issue Date

11/04/1982

Effective Date

11/04/1982

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60617

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006