BEN J SMALL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063324

License Status

CANCELLED

Business

Title

First Name

BEN

Middle

Last Name

SMALL

Business Name

BEN J SMALL MD

Original Issue Date

06/10/2013

Effective Date

06/10/2013

Expiration Date

06/09/2016

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/24/2014