BENJAMIN LAURENCE WAKEFIELD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

NOT RENEWED

Business

First Name

BENJAMIN

Middle

LAURENCE

Last Name

WAKEFIELD

Business Name

BENJAMIN LAURENCE WAKEFIELD

Original Issue Date

12/14/2006

Effective Date

07/16/2020

Expiration Date

07/31/2023

City

NAPERVILLE

State

Zip

60563

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023