BRIAN BENJAMIN BLACKMON D.O. Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036142922

License Status

ACTIVE

Business

Title

D.O.

First Name

BRIAN

Middle

BENJAMIN

Last Name

BLACKMON

Business Name

BRIAN BENJAMIN BLACKMON D.O.

Original Issue Date

04/07/2017

Effective Date

04/15/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60640

County

COOK

Ever Disciplined

LastModifiedDate

04/15/2023