LESZEK J BALLARIN Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

ACTIVE

Business

First Name

LESZEK

Middle

Last Name

BALLARIN

Business Name

LESZEK J BALLARIN

Original Issue Date

03/22/2001

Effective Date

06/08/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60634

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/08/2023