FRED S BALLARD Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****11

License Status

NOT RENEWED

Business

First Name

FRED S

Last Name

BALLARD

Business Name

FRED S BALLARD

Original Issue Date

01/01/1998

Expiration Date

01/31/1985

City

CHICAGO

State

Zip

60624

County

COOK

Controlled Substance Schedule

III IV

Ever Disciplined

LastModifiedDate

09/25/2006