RUDOLPH M BALLENTINE JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036050378

License Status

NOT RENEWED

Business

Title

First Name

RUDOLPH M

Last Name

BALLENTINE JR

Suffix

Business Name

RUDOLPH M BALLENTINE JR MD

Original Issue Date

11/26/1974

Effective Date

11/26/1974

Expiration Date

07/31/1996

City

HONESDALE

State

Zip

18431

County

PENNSYLVANIA

Ever Disciplined

LastModifiedDate

09/20/2006