SCOTT BENJAMIN LUNDGREN DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125026739

License Status

EXPIRED

Business

First Name

SCOTT

Middle

BENJAMIN

Last Name

LUNDGREN

Suffix

Business Name

SCOTT BENJAMIN LUNDGREN DO

Original Issue Date

05/16/1991

Effective Date

05/16/1991

Expiration Date

06/20/1992

City

CHICAGO

State

Zip

60615

County

COOK

Specialty/Qualifier

Family Practice & OMT

Ever Disciplined

LastModifiedDate

09/22/2006