ROBERT WILLIAM BALES MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

NOT RENEWED

Business

First Name

ROBERT

Middle

WILLIAM

Last Name

BALES

Suffix

Business Name

ROBERT WILLIAM BALES MD

Original Issue Date

12/05/2008

Effective Date

12/05/2008

Expiration Date

07/31/2011

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011