DIVYA R BALI Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

NOT RENEWED

Business

First Name

DIVYA R

Last Name

BALI

Business Name

DIVYA R BALI

Original Issue Date

07/27/1983

Effective Date

07/27/1983

Expiration Date

07/31/1999

City

ROSELLE

State

Zip

60172

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011