BENJAMIN WARD DILLE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061982

License Status

CANCELLED

Business

Title

First Name

BENJAMIN

Middle

WARD

Last Name

DILLE

Business Name

BENJAMIN WARD DILLE MD

Original Issue Date

06/28/2012

Effective Date

06/28/2012

Expiration Date

06/27/2015

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

03/24/2014