MANUEL A BALLESCA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125024773

License Status

EXPIRED

Business

First Name

MANUEL

Middle

Last Name

BALLESCA

Business Name

MANUEL A BALLESCA

Original Issue Date

05/14/1990

Effective Date

05/14/1990

Expiration Date

06/24/1993

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006