JASON BENJAMIN WYNBERG MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

CANCELLED

Business

First Name

JASON

Middle

BENJAMIN

Last Name

WYNBERG

Suffix

Business Name

JASON BENJAMIN WYNBERG MD

Original Issue Date

09/08/2004

Effective Date

09/08/2004

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60640

County

COOK

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

10/09/2006