BEN JEFFREY DOLIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

NOT RENEWED

Business

First Name

BEN

Middle

JEFFREY

Last Name

DOLIN

Suffix

Business Name

BEN JEFFREY DOLIN MD

Original Issue Date

12/07/1999

Effective Date

12/07/1999

Expiration Date

07/31/2002

City

KEWANEE

State

Zip

61443

County

HENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020