License holder summary

AMANCIO GOTAUCO BAUTISTA is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for AMANCIO GOTAUCO BAUTISTA is 5422 LAKESIDE DRIVE, NEWBURGH IN 47630. This licensed professional license is not current. The license was granted 01/08/1991 and expired on 06/30/1999.

Indiana

Professional Licensing Agency

AMANCIO GOTAUCO BAUTISTA
Controlled Substance Registration - Physician
License number
01023694B
Date granted
01/08/1991
Date expires
06/30/1999
Class
Controlled Substance Registration - Physician
Status
Expired
Address
5422 LAKESIDE DRIVE, NEWBURGH IN 47630
indianalicensing.org
ID 5905296
LAST UPDATED 2024-03-15 12:47:49 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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