MAXIMO JEFFERY EBALO JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

NOT RENEWED

Business

First Name

MAXIMO JEFFERY

Last Name

EBALO JR

Suffix

Business Name

MAXIMO JEFFERY EBALO JR MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1996

City

EAST MOLINE

State

Zip

61244

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006