ROMEO C BALTAZAR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

NOT RENEWED

Business

First Name

ROMEO C

Last Name

BALTAZAR

Suffix

Business Name

ROMEO C BALTAZAR MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1987

City

WILLOWBROOK

State

Zip

60514

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006