RICHARD E CARBALLO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

NOT RENEWED

Business

First Name

RICHARD E

Last Name

CARBALLO

Suffix

Business Name

RICHARD E CARBALLO MD

Original Issue Date

06/12/1991

Effective Date

06/12/1991

Expiration Date

07/31/1993

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006