ADRIENNE MARTHA BALSAM MD - Medical Doctor License in Illinois | # 125026738

ADRIENNE MARTHA BALSAM MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125026738

License Status

EXPIRED

Business

N

First Name

ADRIENNE

Middle

MARTHA

Last Name

BALSAM

Suffix

MD

Business Name

ADRIENNE MARTHA BALSAM MD

Original Issue Date

05/16/1991

Effective Date

05/16/1991

Expiration Date

06/23/1994

State

IL

Specialty/Qualifier

Psychiatry

Ever Disciplined

N

LastModifiedDate

09/22/2006