EDWIN R BALLELOS Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036089523

License Status

INACTIVE

Business

First Name

EDWIN

Middle

Last Name

BALLELOS

Business Name

EDWIN R BALLELOS

Original Issue Date

08/25/1994

Effective Date

08/25/1994

Expiration Date

07/31/2002

City

MADISON

State

Zip

32341

County

FLORIDA

Ever Disciplined

LastModifiedDate

10/09/2006