BENJAMIN KIESEL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

ACTIVE

Business

Title

First Name

BENJAMIN

Last Name

KIESEL

Business Name

BENJAMIN KIESEL MD

Original Issue Date

11/14/2024

Effective Date

11/14/2024

Expiration Date

07/31/2026

City

LAKE FOREST

State

Zip

60045

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2024