PERPEMELO BABAO BALASTA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000520

License Status

EXPIRED

Business

First Name

PERPEMELO

Middle

BABAO

Last Name

BALASTA

Business Name

PERPEMELO BABAO BALASTA

Original Issue Date

01/01/2013

Effective Date

01/01/2013

Expiration Date

06/30/2013

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Specialty/Qualifier

Family Practice

Ever Disciplined

LastModifiedDate

10/07/2013