BENJAMIN T CHAUCER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071244

License Status

CANCELLED

Business

Title

First Name

BENJAMIN

Middle

Last Name

CHAUCER

Business Name

BENJAMIN T CHAUCER MD

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2020

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/18/2017