DIVYA R BALI Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036058498

License Status

NOT RENEWED

Business

First Name

DIVYA R

Last Name

BALI

Business Name

DIVYA R BALI

Original Issue Date

03/22/1979

Effective Date

05/28/2008

Expiration Date

07/31/2011

City

ALBUQUERQUE

State

Zip

87113

County

NEW MEXICO

Ever Disciplined

LastModifiedDate

11/14/2011