Benjamin Jon Moreno MD
Temporary Medical Permit
Illinois 125049144 Canceled
This Illinois license was held by Benjamin Jon Moreno MD. The license is no longer active. It was granted on 06/01/2005 and expired on 06/30/2008
LICENSE DETAILS
- License Number: 125049144
- Category: TEMPORARY MEDICAL PERMIT
- Status: Canceled
- Date Granted: 06/01/2005 (almost 19 years ago)
- Expiry Date: 06/30/2008 (almost 16 years ago)
LOCATIONS
A Address
ELKHART, IN 46516