BENJAMIN E MONTGOMERY - Medical Doctor License in Illinois | # 125042278

BENJAMIN E MONTGOMERY

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042278

License Status

EXPIRED

Business

N

First Name

BENJAMIN

Middle

E

Last Name

MONTGOMERY

Business Name

BENJAMIN E MONTGOMERY

Original Issue Date

06/19/2001

Effective Date

06/19/2001

Expiration Date

06/30/2004

State

IL

Specialty/Qualifier

Family Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006