NATHANIEL KYLE BALLEK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036129515

License Status

NOT RENEWED

Business

Title

First Name

NATHANIEL

Middle

KYLE

Last Name

BALLEK

Business Name

NATHANIEL KYLE BALLEK MD

Original Issue Date

01/25/2012

Effective Date

01/25/2012

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014