JOHN S BALOCKI DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125019359

License Status

EXPIRED

Business

First Name

JOHN S

Last Name

BALOCKI

Suffix

Business Name

JOHN S BALOCKI DO

Original Issue Date

06/12/1986

Effective Date

06/12/1986

Expiration Date

07/01/1989

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006