STACEY ANNE BENNIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036146120

License Status

ACTIVE

Business

Title

First Name

STACEY

Middle

ANNE

Last Name

BENNIS

Business Name

STACEY ANNE BENNIS MD

Original Issue Date

05/14/2018

Effective Date

04/14/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60661

County

COOK

Ever Disciplined

LastModifiedDate

04/14/2023