PAHL GERALD BENCH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047903

License Status

EXPIRED

Business

First Name

PAHL

Middle

GERALD

Last Name

BENCH

Suffix

Business Name

PAHL GERALD BENCH MD

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2007

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/03/2007