BENJAMIN WILLIAM PHILLIPS Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

ACTIVE

Business

First Name

BENJAMIN

Middle

WILLIAM

Last Name

PHILLIPS

Business Name

BENJAMIN WILLIAM PHILLIPS

Original Issue Date

05/29/2007

Effective Date

06/16/2023

Expiration Date

07/31/2026

City

CANTON

State

Zip

61520

County

FULTON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/16/2023