BEN J MARTIN DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036114292

License Status

NOT RENEWED

Business

First Name

BEN

Middle

Last Name

MARTIN

Suffix

Business Name

BEN J MARTIN DO

Original Issue Date

08/01/2005

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

ENID

State

Zip

73701

County

MADISON

Ever Disciplined

LastModifiedDate

12/06/2011