License holder summary

Carolyn M. Balog is a Optometric Legend Drug Certificate licensed to practice in Indiana. The address on file for Carolyn M. Balog is Bremen IN 46506. This licensed professional license is not current. The license was granted 07/01/1992 and expired on 04/01/2012.

Indiana

Professional Licensing Agency

Carolyn M. Balog
Optometric Legend Drug Certificate
License number
18001983B
Date granted
07/01/1992
Date expires
04/01/2012
Class
Optometric Legend Drug Certificate
Status
Expired
Address
Bremen IN 46506
indianalicensing.org
ID 8284153
LAST UPDATED 2024-04-17 11:43:42 UTC

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