BENJAMIN FOREST PLUCKNETTE DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

Title

First Name

BENJAMIN

Middle

FOREST

Last Name

PLUCKNETTE

Business Name

BENJAMIN FOREST PLUCKNETTE DO

Original Issue Date

08/29/2018

Effective Date

08/29/2018

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61103

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021