LARRY ROBERT BERGSTROM MD - Medical Doctor License in Illinois | # 036066433

LARRY ROBERT BERGSTROM MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036066433

License Status

NOT RENEWED

Business

N

First Name

LARRY ROBERT

Last Name

BERGSTROM

Suffix

MD

Business Name

LARRY ROBERT BERGSTROM MD

Original Issue Date

04/20/1983

Effective Date

04/20/1983

Expiration Date

07/31/1987

State

IL

Ever Disciplined

N

LastModifiedDate

09/20/2006