BENJAMIN DANIEL KRUMSTOK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

NOT RENEWED

Business

First Name

BENJAMIN

Middle

DANIEL

Last Name

KRUMSTOK

Suffix

Business Name

BENJAMIN DANIEL KRUMSTOK MD

Original Issue Date

09/07/1999

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021