MANUEL WILLIAM BALLAS Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000343

License Status

EXPIRED

Business

First Name

MANUEL WILLIAM

Last Name

BALLAS

Business Name

MANUEL WILLIAM BALLAS

Original Issue Date

08/31/1996

Effective Date

08/31/1996

Expiration Date

09/30/1996

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/25/2006