MELISSA ANN BALLENGEE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059868

License Status

EXPIRED

Business

Title

First Name

MELISSA

Middle

ANN

Last Name

BALLENGEE

Business Name

MELISSA ANN BALLENGEE MD

Original Issue Date

06/26/2011

Effective Date

06/26/2011

Expiration Date

06/25/2014

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/13/2015