SANDRA B BENCKENDORF Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036060813

License Status

INACTIVE

Business

First Name

SANDRA

Middle

Last Name

BENCKENDORF

Business Name

SANDRA B BENCKENDORF

Original Issue Date

08/29/1980

Effective Date

07/01/2011

Expiration Date

07/31/2014

City

BERLIN

State

Zip

03570

Ever Disciplined

LastModifiedDate

06/22/2014