RUDOLPH M BALLENTINE JR MD - Medical Doctor License in Pennsylvania | # 036050378

RUDOLPH M BALLENTINE JR MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036050378

License Status

NOT RENEWED

Business

N

Title

MD

First Name

RUDOLPH M

Last Name

BALLENTINE JR

Suffix

MD

Business Name

RUDOLPH M BALLENTINE JR MD

Original Issue Date

11/26/1974

Effective Date

11/26/1974

Expiration Date

07/31/1996

State

PA

Ever Disciplined

N

LastModifiedDate

09/20/2006