BENJAMIN TETSU LISH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****83

License Status

NOT RENEWED

Business

First Name

BENJAMIN

Middle

TETSU

Last Name

LISH

Suffix

Business Name

BENJAMIN TETSU LISH MD

Original Issue Date

12/07/1999

Effective Date

12/07/1999

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006