BENJAMIN DAVID LE MOINE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

NOT RENEWED

Business

Title

First Name

BENJAMIN

Middle

DAVID

Last Name

LE MOINE

Business Name

BENJAMIN DAVID LE MOINE MD

Original Issue Date

08/28/2018

Effective Date

09/10/2020

Expiration Date

07/31/2023

City

ROCKFORD

State

Zip

61103

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023