MARK BENNING Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007872

License Status

NOT RENEWED

Business

First Name

MARK

Last Name

BENNING

Business Name

MARK BENNING

Original Issue Date

08/06/2020

Effective Date

08/06/2020

Expiration Date

03/01/2022

City

FORT HUACHUCA

State

Zip

85613

Ever Disciplined

LastModifiedDate

07/27/2022