ROBERT S BALLER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

NOT RENEWED

Business

First Name

ROBERT S

Last Name

BALLER

Suffix

Business Name

ROBERT S BALLER MD

Original Issue Date

01/01/1997

Effective Date

07/13/2011

Expiration Date

07/31/2014

City

SECOR

State

Zip

61771

County

WOODFORD

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2017