GREGORY S BENSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****88

License Status

NOT RENEWED

Business

First Name

GREGORY S

Last Name

BENSON

Business Name

GREGORY S BENSON

Original Issue Date

02/08/2012

Effective Date

02/08/2012

Expiration Date

09/30/2012

City

MICHIGAN CITY

State

Zip

46360

County

INDIANA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

11/14/2012