RODOLFO BAUTISTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036045521

License Status

NOT RENEWED

Business

First Name

RODOLFO

Last Name

BAUTISTA

Suffix

Business Name

RODOLFO BAUTISTA MD

Original Issue Date

03/27/1972

Effective Date

03/27/1972

Expiration Date

07/31/1987

City

FORT MYER

State

Zip

22211

County

VIRGINIA

Ever Disciplined

LastModifiedDate

09/20/2006