LATANYA TAMARA BENJAMIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

NOT RENEWED

Business

Title

First Name

LATANYA

Middle

TAMARA

Last Name

BENJAMIN

Business Name

LATANYA TAMARA BENJAMIN MD

Original Issue Date

07/18/2008

Effective Date

07/18/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011