JOHN DAVID BENNETT MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

CANCELLED

Business

First Name

JOHN

Middle

DAVID

Last Name

BENNETT

Suffix

Business Name

JOHN DAVID BENNETT MD

Original Issue Date

08/30/2001

Effective Date

08/30/2001

Expiration Date

07/31/2005

City

ELDORADO

State

Zip

62930

County

SALINE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006