ADRIENNE MARTHA BALSAM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125026738

License Status

EXPIRED

Business

First Name

ADRIENNE

Middle

MARTHA

Last Name

BALSAM

Suffix

Business Name

ADRIENNE MARTHA BALSAM MD

Original Issue Date

05/16/1991

Effective Date

05/16/1991

Expiration Date

06/23/1994

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006