JONATHAN T BALAGNA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062745

License Status

EXPIRED

Business

Title

First Name

JONATHAN

Middle

Last Name

BALAGNA

Business Name

JONATHAN T BALAGNA MD

Original Issue Date

06/26/2013

Effective Date

06/26/2013

Expiration Date

06/25/2016

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

08/16/2016