BENJAMIN MATHEW MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

ACTIVE

Business

Title

First Name

BENJAMIN

Last Name

MATHEW

Business Name

BENJAMIN MATHEW MD

Original Issue Date

06/22/2012

Effective Date

07/29/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/18/2025