BENJAMIN DAVID PE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

CANCELLED

Business

First Name

BENJAMIN DAVID

Last Name

Suffix

Business Name

BENJAMIN DAVID PE MD

Original Issue Date

09/09/1993

Effective Date

04/19/2011

Expiration Date

07/31/2014

City

DANVILLE

State

Zip

61832

County

VERMILION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2014