KARMINA PASCUAL BAUTISTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

NOT RENEWED

Business

First Name

KARMINA

Middle

PASCUAL

Last Name

BAUTISTA

Suffix

Business Name

KARMINA PASCUAL BAUTISTA MD

Original Issue Date

07/11/2006

Effective Date

07/11/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

11/06/2008