JORDAN MATTHEW BALTER DO

Business Entity
CANCELLED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****88

CANCELLED

N

JORDAN

MATTHEW

BALTER

DO

JORDAN MATTHEW BALTER DO

10/18/2007

08/05/2008

07/31/2011

GRANITE CITY

IL

62040

MADISON

PRACTITIONER

II III IV V

N

04/07/2011