BENJAMIN WILLIAM LEACOCK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

ACTIVE

Business

Title

First Name

BENJAMIN

Middle

WILLIAM

Last Name

LEACOCK

Business Name

BENJAMIN WILLIAM LEACOCK MD

Original Issue Date

03/19/2019

Effective Date

07/05/2023

Expiration Date

07/31/2026

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/05/2023