EDWIN R BALLELOS - Medical Doctor License in Florida | # 036089523

EDWIN R BALLELOS

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036089523

License Status

INACTIVE

Business

N

First Name

EDWIN

Middle

R

Last Name

BALLELOS

Business Name

EDWIN R BALLELOS

Original Issue Date

08/25/1994

Effective Date

08/25/1994

Expiration Date

07/31/2002

State

FL

Ever Disciplined

N

LastModifiedDate

10/09/2006