SALLY JO BALLARD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001066

License Status

NOT RENEWED

Business

First Name

SALLY

Middle

Last Name

BALLARD

Business Name

SALLY JO BALLARD

Original Issue Date

07/16/1998

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

HERRIN

State

Zip

62948

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

09/22/2010

Case Number

1997051270

Action

Fine

Discipline Start Date

08/05/1998