JOSIAH BALLANTINE MD - Medical Doctor License in Illinois | # 125073593

JOSIAH BALLANTINE MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125073593

License Status

EXPIRED

Business

N

Title

MD

First Name

JOSIAH

Last Name

BALLANTINE

Business Name

JOSIAH BALLANTINE MD

Original Issue Date

06/23/2019

Effective Date

06/23/2019

Expiration Date

06/22/2022

State

IL

Specialty/Qualifier

Pediatrics

Ever Disciplined

N

LastModifiedDate

10/11/2022