CRISPULO T BENITO JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

NOT RENEWED

Business

Title

First Name

CRISPULO

Middle

Last Name

BENITO

Suffix

Business Name

CRISPULO T BENITO JR MD

Original Issue Date

03/11/1992

Effective Date

03/11/1992

Expiration Date

07/31/2008

City

OAK FOREST

State

Zip

60452

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011