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