BALBINO EDUARDO LOPEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

License Status

NOT RENEWED

Business

Title

First Name

BALBINO

Middle

EDUARDO

Last Name

LOPEZ

Business Name

BALBINO EDUARDO LOPEZ MD

Original Issue Date

06/28/2017

Effective Date

09/17/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60642

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023