JEFFERSON I BALIN - Medical Doctor License in Illinois | # 125047335

JEFFERSON I BALIN

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047335

License Status

EXPIRED

Business

N

First Name

JEFFERSON

Middle

I

Last Name

BALIN

Business Name

JEFFERSON I BALIN

Original Issue Date

06/21/2004

Effective Date

06/21/2004

Expiration Date

06/20/2005

State

IL

Ever Disciplined

N

LastModifiedDate

09/22/2006