RICKY J BALLOU MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036102319

License Status

INACTIVE

Business

First Name

RICKY

Middle

Last Name

BALLOU

Suffix

Business Name

RICKY J BALLOU MD

Original Issue Date

04/10/2000

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

HARRISBURG

State

Zip

62946

County

SALINE

Ever Disciplined

LastModifiedDate

05/06/2008