JULIANA VAN DER MEIJDEN BENNISON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

NOT RENEWED

Business

Title

First Name

JULIANA

Middle

VAN DER MEIJDEN

Last Name

BENNISON

Business Name

JULIANA VAN DER MEIJDEN BENNISON MD

Original Issue Date

07/26/2021

Effective Date

07/26/2021

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023