ROBERT S BALLER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036040225

License Status

NOT RENEWED

Business

First Name

ROBERT S

Last Name

BALLER

Suffix

Business Name

ROBERT S BALLER MD

Original Issue Date

03/02/1966

Effective Date

04/29/2014

Expiration Date

07/31/2017

City

SECOR

State

Zip

61771

County

WOODFORD

Ever Disciplined

LastModifiedDate

11/01/2017