SCOTT BENJAMIN LUNDGREN DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036099964

License Status

NOT RENEWED

Business

First Name

SCOTT

Middle

BENJAMIN

Last Name

LUNDGREN

Suffix

Business Name

SCOTT BENJAMIN LUNDGREN DO

Original Issue Date

04/02/1999

Effective Date

04/02/1999

Expiration Date

07/31/2002

City

KENOSHA

State

Zip

53144

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/07/2016