JORGE CARBALLIDO MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036042247

License Status

INACTIVE

Business

First Name

JORGE

Last Name

CARBALLIDO

Suffix

Business Name

JORGE CARBALLIDO MD

Original Issue Date

10/23/1968

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

WEST PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

06/10/2008