RICHARD E CARBALLO MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125022367

License Status

EXPIRED

Business

First Name

RICHARD E

Last Name

CARBALLO

Suffix

Business Name

RICHARD E CARBALLO MD

Original Issue Date

05/13/1988

Effective Date

05/13/1988

Expiration Date

07/01/1991

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Addiction Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006