Indiana
Professional Licensing Agency
AMANCIO G BAUTISTA MD
Medical Licensing Board - Medical Corporation
License number
50001189A
Date granted
03/23/1977
Date expires
01/31/1990
Class
Medical Licensing Board - Medical Corporation
Status
Expired
Address
5422 LAKESIDE DRIVE, NEWBURGH IN 47630
indianalicensing.org
ID 24832642
LAST UPDATED 2026-05-01 04:43:12 UTC
LAST UPDATED 2026-05-01 04:43:12 UTC
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