MITCHELL LEE BASTILLO Speech-Language Pathologist License verification

Business Entity

ACTIVE

License Type

Speech-Language Pathologist

Description

SPEECH LANGUAGE PATHOLOGIST

License Number

146013465

License Status

ACTIVE

Business

First Name

MITCHELL

Middle

LEE

Last Name

BASTILLO

Business Name

MITCHELL LEE BASTILLO

Original Issue Date

08/17/2016

Effective Date

10/08/2025

Expiration Date

10/31/2027

City

OAK PARK

State

Zip

60304

County

COOK

Ever Disciplined

LastModifiedDate

10/08/2025