PEDRO ANTONIO BALLESTER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****56

License Status

NOT RENEWED

Business

First Name

PEDRO

Middle

ANTONIO

Last Name

BALLESTER

Suffix

Business Name

PEDRO ANTONIO BALLESTER MD

Original Issue Date

05/13/1998

Effective Date

05/13/1998

Expiration Date

07/31/1999

City

MATTOON

State

Zip

61938

County

COLES

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006