BENJAMIN JAMES LEAK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

ACTIVE

Business

First Name

BENJAMIN

Middle

JAMES

Last Name

LEAK

Suffix

Business Name

BENJAMIN JAMES LEAK MD

Original Issue Date

05/02/2003

Effective Date

04/19/2023

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/19/2023