DAVID SALOMON BALLESTAS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

NOT RENEWED

Business

First Name

DAVID SALOMON

Last Name

BALLESTAS

Suffix

Business Name

DAVID SALOMON BALLESTAS MD

Original Issue Date

12/01/1982

Effective Date

12/01/1982

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2017