BENJAMIN FREDERICK BRANCH DO - Medical Doctor License in Illinois | # 125051742

BENJAMIN FREDERICK BRANCH DO

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051742

License Status

EXPIRED

Business

N

First Name

BENJAMIN

Middle

FREDERICK

Last Name

BRANCH

Suffix

DO

Business Name

BENJAMIN FREDERICK BRANCH DO

Original Issue Date

07/01/2006

Effective Date

07/01/2006

Expiration Date

06/30/2009

State

IL

Ever Disciplined

N

LastModifiedDate

07/15/2009