BENJAMIN MOULTRIE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036038273

License Status

NOT RENEWED

Business

First Name

BENJAMIN

Last Name

MOULTRIE

Suffix

Business Name

BENJAMIN MOULTRIE MD

Original Issue Date

12/26/1962

Effective Date

12/26/1962

City

CHICAGO

State

Zip

60628

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006