JEFFERSON I BALIN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047335

License Status

EXPIRED

Business

First Name

JEFFERSON

Middle

Last Name

BALIN

Business Name

JEFFERSON I BALIN

Original Issue Date

06/21/2004

Effective Date

06/21/2004

Expiration Date

06/20/2005

City

OAK PARK

State

Zip

60302

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006