BENJAMIN R BRYAN Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112320

License Status

INACTIVE

Business

First Name

BENJAMIN

Middle

Last Name

BRYAN

Business Name

BENJAMIN R BRYAN

Original Issue Date

09/13/2004

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

NEW YORK

State

Zip

10010

Ever Disciplined

LastModifiedDate

04/17/2008