BENJAMIN SCOTT WALLIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

ACTIVE

Business

Title

First Name

BENJAMIN

Middle

SCOTT

Last Name

WALLIS

Business Name

BENJAMIN SCOTT WALLIS MD

Original Issue Date

05/18/2015

Effective Date

06/21/2023

Expiration Date

07/31/2026

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/21/2023