THOMAS A MAIBENCO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

Last Name

MAIBENCO

Suffix

Business Name

THOMAS A MAIBENCO MD

Original Issue Date

11/18/1991

Effective Date

11/18/1991

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020