BENJAMIN L PALLA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****73

License Status

NOT RENEWED

Business

First Name

BENJAMIN

Middle

Last Name

PALLA

Business Name

BENJAMIN L PALLA

Original Issue Date

09/27/2018

Effective Date

09/11/2021

Expiration Date

09/30/2024

City

CHICAGO

State

Zip

60612

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025