STEPHEN G BENNETT MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125018111

License Status

EXPIRED

Business

First Name

STEPHEN G

Last Name

BENNETT

Suffix

Business Name

STEPHEN G BENNETT MD

Original Issue Date

06/13/1985

Effective Date

06/13/1985

Expiration Date

07/01/1988

City

PEORIA

State

Zip

61636

County

PEORIA

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006