MAXIMO JEFFERY EBALO JR MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036059762

License Status

INACTIVE

Business

First Name

MAXIMO JEFFERY

Last Name

EBALO JR

Suffix

Business Name

MAXIMO JEFFERY EBALO JR MD

Original Issue Date

11/09/1979

Effective Date

11/09/1979

Expiration Date

07/31/1996

City

EAST MOLINE

State

Zip

61244

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

09/20/2006