PAHL GERALD BENCH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

NOT RENEWED

Business

First Name

PAHL

Middle

GERALD

Last Name

BENCH

Suffix

Business Name

PAHL GERALD BENCH MD

Original Issue Date

07/02/2007

Effective Date

07/02/2007

Expiration Date

07/31/2008

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008