Fallon Banton

Medical doctor

Roanoke, United States

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Full name

Fallon Banton

Job Title

Medical Doctor

Location

Roanoke, VA, USA

LIC ID

169501

Current License Expiration Date

31/01/2026

Original Date

30/11/2023

Professional Rank Code

Effective Date

30/11/2023

Board Action Indicator

License Status Description

CLEAR

License Active Status Description

ACTIVE

Country Description

Out of State

Practice Location Address Line 1

901 22nd Ave South

Practice Location Address City

SAINT PETERSBURG

Practice Location Address State

Practice Location Address Zipcode

33705

Mode Code

Dispensing Practitioner

Prescribing Indicator

Dispensing Indicator

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