Indiana
Professional Licensing Agency
Perpemelo Babao Balasta, III
Medical Residency Permit
License number
11015493A
Date granted
05/25/2010
Date expires
06/30/2012
Class
Medical Residency Permit
Status
Expired
Address
South Bend IN 46617
indianalicensing.org
ID 5996699
LAST UPDATED 2026-04-26 20:33:50 UTC
LAST UPDATED 2026-04-26 20:33:50 UTC
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