BENJAMIN ANTONIO MARTELL LAZO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125084212

License Status

ACTIVE

Business

Title

First Name

BENJAMIN

Middle

ANTONIO

Last Name

MARTELL LAZO

Business Name

BENJAMIN ANTONIO MARTELL LAZO MD

Original Issue Date

07/01/2024

Effective Date

07/01/2024

Expiration Date

06/30/2027

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

06/05/2024