BENJAMIN MARK EASTBURG MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125081783

License Status

CANCELLED

Business

Title

First Name

BENJAMIN

Middle

MARK

Last Name

EASTBURG

Business Name

BENJAMIN MARK EASTBURG MD

Original Issue Date

07/01/2023

Effective Date

07/01/2023

Expiration Date

06/30/2026

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/16/2026