BENJAMIN MICHAEL GRUGAN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125073388

License Status

EXPIRED

Business

Title

First Name

BENJAMIN

Middle

MICHAEL

Last Name

GRUGAN

Business Name

BENJAMIN MICHAEL GRUGAN MD

Original Issue Date

07/01/2021

Effective Date

07/01/2021

Expiration Date

06/30/2022

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

10/11/2022