JOHN MICHAEL BALLESTER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036100207

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

MICHAEL

Last Name

BALLESTER

Suffix

Business Name

JOHN MICHAEL BALLESTER MD

Original Issue Date

05/12/1999

Effective Date

05/12/1999

Expiration Date

07/31/2002

City

WEXFORD

State

Zip

15090

County

PENNSYLVANIA

Ever Disciplined

LastModifiedDate

10/09/2006