BENJAMIN BRUCE GEORGE MORI M.D. Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125073070

License Status

CANCELLED

Business

Title

M.D.

First Name

BENJAMIN

Middle

BRUCE GEORGE

Last Name

MORI

Business Name

BENJAMIN BRUCE GEORGE MORI M.D.

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2021

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

05/21/2018