TARA LORENCE VAN BENNEKOM
Osteopathic Physician
Indiana 02001619A Expired Non-Renewable
This Indiana license was held by TARA LORENCE VAN BENNEKOM. The license is no longer active. It was granted on 01/26/1995 and expired on 06/30/2003
LICENSE DETAILS
- License Number: 02001619A
- Category: Osteopathic Physician
- Status: Expired Non-Renewable
- Date Granted: 01/26/1995 (over 30 years ago)
- Expiry Date: 06/30/2003 (almost 22 years ago)
LOCATIONS
A Address
ORANGE PARK FL 32073