DEREK JOHN BENNING DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019033856

License Status

ACTIVE

Business

Title

DMD

First Name

DEREK

Middle

JOHN

Last Name

BENNING

Business Name

DEREK JOHN BENNING DMD

Original Issue Date

06/28/2022

Effective Date

09/04/2024

Expiration Date

09/30/2027

City

COLLINSVILLE

State

Zip

62234

County

MADISON

Ever Disciplined

LastModifiedDate

09/04/2024