WAYNE DAVID LEROY BENTHAM MD - Medical Doctor License in Wisconsin | # 036153548

WAYNE DAVID LEROY BENTHAM MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036153548

License Status

NOT RENEWED

Business

N

Title

MD

First Name

WAYNE

Middle

DAVID LEROY

Last Name

BENTHAM

Business Name

WAYNE DAVID LEROY BENTHAM MD

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

07/31/2023

State

WI

Ever Disciplined

N

LastModifiedDate

11/30/2023