BENJAMIN PAUL ROOSE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

ACTIVE

Business

Title

First Name

BENJAMIN

Middle

PAUL

Last Name

ROOSE

Business Name

BENJAMIN PAUL ROOSE MD

Original Issue Date

09/18/2019

Effective Date

07/15/2023

Expiration Date

07/31/2026

City

HERRIN

State

Zip

62948

County

WILLIAMSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/15/2023