DIANNE J BENNETT MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036080980

License Status

INACTIVE

Business

First Name

DIANNE J

Last Name

BENNETT

Suffix

Business Name

DIANNE J BENNETT MD

Original Issue Date

07/14/1990

Effective Date

07/14/1990

Expiration Date

07/31/1996

City

STONE MOUNTAIN

State

Zip

30087

County

GEORGIA

Ever Disciplined

LastModifiedDate

09/20/2006