TERRY J BALAGNA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125017664

License Status

EXPIRED

Business

First Name

TERRY J

Last Name

BALAGNA

Suffix

Business Name

TERRY J BALAGNA MD

Original Issue Date

09/04/1984

Effective Date

09/04/1984

Expiration Date

07/01/1986

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006