MICHELLE A BENJAMIN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****86

License Status

NOT RENEWED

Business

First Name

MICHELLE A

Last Name

BENJAMIN

Business Name

MICHELLE A BENJAMIN

Original Issue Date

03/07/2001

Effective Date

03/07/2001

Expiration Date

03/01/2004

City

CHICAGO

State

Zip

60608

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006