DIANN DEMETRIA BENNETT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036107289

License Status

NOT RENEWED

Business

First Name

DIANN

Middle

DEMETRIA

Last Name

BENNETT

Suffix

Business Name

DIANN DEMETRIA BENNETT MD

Original Issue Date

06/28/2002

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Ever Disciplined

LastModifiedDate

11/14/2011