GAYLORD W BENNETT MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036046546

License Status

INACTIVE

Business

First Name

GAYLORD W

Last Name

BENNETT

Suffix

Business Name

GAYLORD W BENNETT MD

Original Issue Date

10/19/1972

Effective Date

10/19/1972

Expiration Date

07/31/1993

City

BORING

State

Zip

97007

County

OREGON

Ever Disciplined

LastModifiedDate

09/20/2006