PRAKASH BALAN - Medical Doctor License in Illinois | # 125048682

PRAKASH BALAN

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048682

License Status

EXPIRED

Business

N

First Name

PRAKASH

Last Name

BALAN

Business Name

PRAKASH BALAN

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2007

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

07/03/2007