SUSAN C BALLIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

ACTIVE

Business

First Name

SUSAN

Middle

Last Name

BALLIS

Suffix

Business Name

SUSAN C BALLIS MD

Original Issue Date

10/18/1999

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

DEERFIELD

State

Zip

60015

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023