BEN JASPER BRYANT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

First Name

BEN

Middle

JASPER

Last Name

BRYANT

Suffix

Business Name

BEN JASPER BRYANT MD

Original Issue Date

08/05/2009

Effective Date

04/18/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014