BENJAMIN THOMAS GIELDA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

NOT RENEWED

Business

First Name

BENJAMIN

Middle

THOMAS

Last Name

GIELDA

Suffix

Business Name

BENJAMIN THOMAS GIELDA MD

Original Issue Date

01/28/2011

Effective Date

06/21/2011

Expiration Date

07/31/2014

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014