BENJAMIN ADAM INGRAHAM DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125064513

License Status

CANCELLED

Business

Title

First Name

BENJAMIN

Middle

ADAM

Last Name

INGRAHAM

Business Name

BENJAMIN ADAM INGRAHAM DO

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2019

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Brain Injury Medicine and Rehabilitation

Ever Disciplined

LastModifiedDate

06/20/2018