BENJAMIN MARCUS MERVAK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060037

License Status

EXPIRED

Business

Title

First Name

BENJAMIN

Middle

MARCUS

Last Name

MERVAK

Business Name

BENJAMIN MARCUS MERVAK MD

Original Issue Date

06/24/2011

Effective Date

06/24/2011

Expiration Date

06/23/2012

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

08/29/2012