TARA CARMEN BENTON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050752

License Status

EXPIRED

Business

First Name

TARA

Middle

CARMEN

Last Name

BENTON

Suffix

Business Name

TARA CARMEN BENTON MD

Original Issue Date

06/19/2006

Effective Date

06/19/2006

Expiration Date

06/18/2009

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

07/15/2009