HARVEY J BALTHASER MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****52

NOT RENEWED

N

HARVEY J

BALTHASER

MD

HARVEY J BALTHASER MD

11/03/1982

11/03/1982

07/31/1984

CHICAGO

IL

60614

COOK

II III IV V

N

09/26/2006