BENJAMIN R BRYAN Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

CANCELLED

Business

First Name

BENJAMIN

Middle

Last Name

BRYAN

Business Name

BENJAMIN R BRYAN

Original Issue Date

04/14/2005

Effective Date

04/14/2005

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008