BENNETT JOSEPH WAXSE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071220

License Status

EXPIRED

Business

Title

First Name

BENNETT

Middle

JOSEPH

Last Name

WAXSE

Business Name

BENNETT JOSEPH WAXSE MD

Original Issue Date

06/24/2020

Effective Date

06/24/2020

Expiration Date

06/23/2021

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine/Pediatrics

Ever Disciplined

LastModifiedDate

10/11/2022