ANITA JAWQUIN BERGMAN - Dentist License in Illinois | # 020002178

ANITA JAWQUIN BERGMAN

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020002178

License Status

NOT RENEWED

Business

N

First Name

ANITA JAWQUIN

Last Name

BERGMAN

Business Name

ANITA JAWQUIN BERGMAN

Original Issue Date

07/03/1974

Effective Date

07/03/1974

Expiration Date

09/30/1984

State

IL

Ever Disciplined

N

LastModifiedDate

10/12/2005