CYNTHIA P BALLEZA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

NOT RENEWED

Business

First Name

CYNTHIA P

Last Name

BALLEZA

Suffix

Business Name

CYNTHIA P BALLEZA MD

Original Issue Date

01/10/1983

Effective Date

01/10/1983

Expiration Date

07/31/2005

City

CRETE

State

Zip

60417

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006