TARA LORENCE VAN BENNEKOM
Department Of Health - Osteopathic Physician
Florida OS8054 Active
This Florida license is held by TARA LORENCE VAN BENNEKOM. The license is currently active. It was granted on 01/01/1996 and expired on 03/31/2016
LICENSE DETAILS
- License Number: OS8054
- Category: Osteopathic Physician
- Status: Active
- Date Granted: 01/01/1996 (over 29 years ago)
- Expiry Date: 03/31/2016 (about 9 years ago)
LOCATIONS
A Primary Practice Address
ST. AUGUSTINE PEDIATRIC ASSOCI, 493 PROSPERITY LAKE DRIVE, SAINT AUGUSTINE, FL 32092
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