DIANN DEMETRIA BENNETT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

NOT RENEWED

Business

First Name

DIANN

Middle

DEMETRIA

Last Name

BENNETT

Suffix

Business Name

DIANN DEMETRIA BENNETT MD

Original Issue Date

07/03/2002

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011