BENJAMIN JAMES MOGNI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074226

License Status

CANCELLED

Business

Title

First Name

BENJAMIN

Middle

JAMES

Last Name

MOGNI

Business Name

BENJAMIN JAMES MOGNI MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

05/21/2019