JONATHAN BENJAMIN IDA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

ACTIVE

Business

Title

First Name

JONATHAN

Middle

BENJAMIN

Last Name

IDA

Business Name

JONATHAN BENJAMIN IDA MD

Original Issue Date

01/25/2011

Effective Date

06/02/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/02/2023