SUSAN C BALLIS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036177

License Status

EXPIRED

Business

First Name

SUSAN

Middle

Last Name

BALLIS

Suffix

Business Name

SUSAN C BALLIS MD

Original Issue Date

05/20/1997

Effective Date

05/20/1997

Expiration Date

06/29/2000

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006