BENJAMIN TETSU LISH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036506

License Status

EXPIRED

Business

First Name

BENJAMIN

Middle

TETSU

Last Name

LISH

Suffix

Business Name

BENJAMIN TETSU LISH MD

Original Issue Date

06/06/1997

Effective Date

06/06/1997

Expiration Date

06/30/2000

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006