BENJAMIN R BRYAN - Medical Doctor License in Illinois | # 125043957

BENJAMIN R BRYAN

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125043957

License Status

EXPIRED

Business

N

First Name

BENJAMIN

Middle

R

Last Name

BRYAN

Business Name

BENJAMIN R BRYAN

Original Issue Date

06/18/2002

Effective Date

06/18/2002

Expiration Date

06/17/2005

State

IL

Specialty/Qualifier

Psychiatry

Ever Disciplined

N

LastModifiedDate

09/22/2006