BENJAMIN KIESEL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074610

License Status

CANCELLED

Business

Title

First Name

BENJAMIN

Last Name

KIESEL

Business Name

BENJAMIN KIESEL MD

Original Issue Date

06/23/2022

Effective Date

06/23/2022

Expiration Date

06/22/2023

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

01/28/2022