BENNETT S PARK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125012858

License Status

EXPIRED

Business

First Name

BENNETT S

Last Name

PARK

Suffix

Business Name

BENNETT S PARK MD

Original Issue Date

06/17/1981

Effective Date

06/17/1981

Expiration Date

07/01/1983

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/22/2006