BENJAMIN NELS CANTRILL DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068088

License Status

CANCELLED

Business

Title

First Name

BENJAMIN

Middle

NELS

Last Name

CANTRILL

Business Name

BENJAMIN NELS CANTRILL DO

Original Issue Date

06/24/2016

Effective Date

06/24/2016

Expiration Date

06/23/2019

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/25/2016