PHILIP S BENJAKUL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039680

License Status

CANCELLED

Business

First Name

PHILIP

Middle

Last Name

BENJAKUL

Suffix

Business Name

PHILIP S BENJAKUL MD

Original Issue Date

07/01/1999

Effective Date

07/01/1999

Expiration Date

06/30/2002

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006