BENNETT SETH WALSTATTER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036127015

License Status

NOT RENEWED

Business

First Name

BENNETT

Middle

SETH

Last Name

WALSTATTER

Suffix

Business Name

BENNETT SETH WALSTATTER MD

Original Issue Date

12/28/2010

Effective Date

07/13/2017

Expiration Date

09/30/2020

City

ST AUGUSTINE

State

Zip

32092

County

FLORIDA

Ever Disciplined

LastModifiedDate

01/14/2021

Case Number

2017010429

Action

Fine

Discipline Start Date

12/22/2017

Discipline Reason

based on sister-state discipline in the State of Michigan.