CRISPULO T BENITO JR MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125024611

License Status

EXPIRED

Business

Title

First Name

CRISPULO

Middle

Last Name

BENITO

Suffix

Business Name

CRISPULO T BENITO JR MD

Original Issue Date

01/29/1990

Effective Date

01/29/1990

Expiration Date

01/29/1992

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006