BRIAN KEITH BONISH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

NOT RENEWED

Business

Title

First Name

BRIAN

Middle

KEITH

Last Name

BONISH

Business Name

BRIAN KEITH BONISH MD

Original Issue Date

11/30/2018

Effective Date

11/30/2018

Expiration Date

09/30/2020

City

BERWYN

State

Zip

60402

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021