JONATHAN DAVID BENSON DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055844

License Status

CANCELLED

Business

Title

First Name

JONATHAN

Middle

DAVID

Last Name

BENSON

Business Name

JONATHAN DAVID BENSON DO

Original Issue Date

08/01/2010

Effective Date

08/01/2010

Expiration Date

07/31/2012

City

NORMAL

State

Zip

61761

County

MCLEAN

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/30/2010