BENJAMIN E MONTGOMERY Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

ACTIVE

Business

First Name

BENJAMIN

Middle

Last Name

MONTGOMERY

Business Name

BENJAMIN E MONTGOMERY

Original Issue Date

09/24/2003

Effective Date

04/20/2023

Expiration Date

07/31/2026

City

JACKSONVILLE

State

Zip

62650

County

MORGAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/20/2023