GREGORY L BENNETT MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027104

License Status

EXPIRED

Business

First Name

GREGORY L

Last Name

BENNETT

Suffix

Business Name

GREGORY L BENNETT MD

Original Issue Date

06/06/1991

Effective Date

06/06/1991

Expiration Date

06/30/1994

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006