HAZEL BENZON MANZANO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

NOT RENEWED

Business

First Name

HAZEL

Middle

BENZON

Last Name

MANZANO

Business Name

HAZEL BENZON MANZANO

Original Issue Date

06/13/2001

Effective Date

08/01/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017