KRISTINE M BENNETT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****41

License Status

NOT RENEWED

Business

First Name

KRISTINE

Middle

Last Name

BENNETT

Business Name

KRISTINE M BENNETT

Original Issue Date

02/22/2001

Effective Date

01/21/2014

Expiration Date

03/01/2016

City

OSWEGO

State

Zip

60543

County

KENDALL

Ever Disciplined

LastModifiedDate

04/25/2016