CAROL BRYAN BALLOU MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036058329

License Status

ACTIVE

Business

First Name

CAROL BRYAN

Last Name

BALLOU

Suffix

Business Name

CAROL BRYAN BALLOU MD

Original Issue Date

02/21/1979

Effective Date

07/11/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60608

County

COOK

Ever Disciplined

LastModifiedDate

07/11/2023