KRISTINE M BENNETT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000828

License Status

NOT RENEWED

Business

First Name

KRISTINE

Middle

Last Name

BENNETT

Business Name

KRISTINE M BENNETT

Original Issue Date

01/06/1997

Effective Date

01/21/2014

Expiration Date

03/01/2016

City

OSWEGO

State

Zip

60543

County

KENDALL

Ever Disciplined

LastModifiedDate

04/25/2016