TARA Z BENNETT MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

ACTIVE

Business

First Name

TARA Z

Last Name

BENNETT

Suffix

Business Name

TARA Z BENNETT MD

Original Issue Date

03/02/1994

Effective Date

04/12/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2023