TARA CARMEN BENTON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036122800

License Status

NOT RENEWED

Business

First Name

TARA

Middle

CARMEN

Last Name

BENTON

Suffix

Business Name

TARA CARMEN BENTON MD

Original Issue Date

03/06/2009

Effective Date

04/20/2011

Expiration Date

07/31/2014

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Ever Disciplined

LastModifiedDate

11/17/2014