Stephen Leroy Ballard
Controlled Substance Registration - Dentist
Indiana 12008641B Revoked
This Indiana license was held by Stephen Leroy Ballard. The license is no longer active. It was granted on 11/30/1986 and expired on 03/01/2008
LICENSE DETAILS
- License Number: 12008641B
- Category: CSR-Dentist
- Status: Revoked
- Date Granted: 11/30/1986 (over 38 years ago)
- Expiry Date: 03/01/2008 (about 17 years ago)
LOCATIONS
A Address
1030 WASHINGTON AVENUE, EVANSVILLE IN 47714