BENJAMIN CHARLES JOHNSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045035

License Status

CANCELLED

Business

First Name

BENJAMIN

Middle

CHARLES

Last Name

JOHNSON

Suffix

Business Name

BENJAMIN CHARLES JOHNSON MD

Original Issue Date

06/24/2002

Effective Date

06/24/2002

Expiration Date

06/23/2007

City

GURNEE

State

Zip

60031

Specialty/Qualifier

Otolaryngology

Ever Disciplined

LastModifiedDate

09/22/2006