ANDREW BENNETT Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042526

License Status

CANCELLED

Business

First Name

ANDREW

Last Name

BENNETT

Business Name

ANDREW BENNETT

Original Issue Date

06/24/2001

Effective Date

06/24/2001

Expiration Date

06/23/2004

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/22/2006