BENJAMIN U SAMUEL Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

ACTIVE

Business

First Name

BENJAMIN U

Last Name

SAMUEL

Business Name

BENJAMIN U SAMUEL

Original Issue Date

07/28/2004

Effective Date

06/13/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/13/2023