ELPIDIA H BALBASTRO MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027006

License Status

EXPIRED

Business

First Name

ELPIDIA H

Last Name

BALBASTRO

Suffix

Business Name

ELPIDIA H BALBASTRO MD

Original Issue Date

05/30/1991

Effective Date

05/30/1991

Expiration Date

06/19/1994

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006