BENJAMIN E MONTGOMERY Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036109933

License Status

ACTIVE

Business

First Name

BENJAMIN

Middle

Last Name

MONTGOMERY

Business Name

BENJAMIN E MONTGOMERY

Original Issue Date

08/15/2003

Effective Date

04/20/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Ever Disciplined

LastModifiedDate

04/20/2023