JEDIDIAH AMOS BALLARD DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036147055

License Status

NOT RENEWED

Business

Title

First Name

JEDIDIAH

Middle

AMOS

Last Name

BALLARD

Business Name

JEDIDIAH AMOS BALLARD DO

Original Issue Date

07/30/2018

Effective Date

07/30/2018

Expiration Date

09/30/2020

City

AUGUSTA

State

Zip

30912

Ever Disciplined

LastModifiedDate

01/14/2021