DOROTHY BENNETT MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125078194

License Status

CANCELLED

Business

Title

First Name

DOROTHY

Last Name

BENNETT

Business Name

DOROTHY BENNETT MD

Original Issue Date

07/01/2021

Effective Date

07/01/2021

Expiration Date

06/30/2024

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/26/2021