BENIGNO WALDO A DAGAN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

NOT RENEWED

Business

First Name

BENIGNO WALDO A

Last Name

DAGAN

Business Name

BENIGNO WALDO A DAGAN

Original Issue Date

06/02/1997

Effective Date

06/02/1997

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60613

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006