TARA Z BENNETT MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125024744

License Status

EXPIRED

Business

First Name

TARA Z

Last Name

BENNETT

Suffix

Business Name

TARA Z BENNETT MD

Original Issue Date

05/08/1990

Effective Date

05/08/1990

Expiration Date

06/30/1994

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006