ROBERT BALLARD JOHN Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000109

License Status

INACTIVE

Business

First Name

ROBERT BALLARD

Last Name

JOHN

Business Name

ROBERT BALLARD JOHN

Original Issue Date

01/01/1998

Expiration Date

09/30/2002

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

LastModifiedDate

10/17/2005