LESZEK J BALLARIN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125038660

License Status

EXPIRED

Business

First Name

LESZEK

Middle

Last Name

BALLARIN

Business Name

LESZEK J BALLARIN

Original Issue Date

07/01/1998

Effective Date

07/01/1998

Expiration Date

06/30/2001

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006