A L BENNETT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036093647

License Status

NOT RENEWED

Business

First Name

A L

Last Name

BENNETT

Suffix

Business Name

A L BENNETT MD

Original Issue Date

07/19/1996

Effective Date

07/19/1996

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60616

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006