BENJAMIN ADAM INGRAHAM DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****82

License Status

NOT RENEWED

Business

Title

First Name

BENJAMIN

Middle

ADAM

Last Name

INGRAHAM

Business Name

BENJAMIN ADAM INGRAHAM DO

Original Issue Date

01/31/2019

Effective Date

01/31/2019

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021