HEATHER ANN BALLARD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

NOT RENEWED

Business

Title

First Name

HEATHER

Middle

ANN

Last Name

BALLARD

Business Name

HEATHER ANN BALLARD MD

Original Issue Date

10/02/2018

Effective Date

10/02/2018

Expiration Date

09/30/2020

City

NORTHBROOK

State

Zip

60062

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021