KEITH H BENZULY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

ACTIVE

Business

First Name

KEITH H

Last Name

BENZULY

Suffix

Business Name

KEITH H BENZULY MD

Original Issue Date

07/22/1996

Effective Date

07/15/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/15/2023