KELLY MARY BALTAZAR Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED CHIROPRACTIC PHYSICIAN

License Number

038010901

License Status

INACTIVE

Business

First Name

KELLY

Middle

MARY

Last Name

BALTAZAR

Business Name

KELLY MARY BALTAZAR

Original Issue Date

02/14/2007

Effective Date

05/26/2014

Expiration Date

07/31/2017

City

WADSWORTH

State

Zip

60083

County

LAKE

Ever Disciplined

LastModifiedDate

04/11/2017