JOSE S BALLESTEROS JR MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****19

License Status

CANCELLED

Business

Title

First Name

JOSE S

Last Name

BALLESTEROS JR

Suffix

Business Name

JOSE S BALLESTEROS JR MD

Original Issue Date

01/01/1997

Expiration Date

09/01/1982

City

CHICAGO

State

Zip

60625

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006