BRENDA W BERGESON - Medical Doctor License in Illinois | # 125039310

BRENDA W BERGESON

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039310

License Status

EXPIRED

Business

N

First Name

BRENDA

Middle

W

Last Name

BERGESON

Business Name

BRENDA W BERGESON

Original Issue Date

06/14/1999

Effective Date

06/14/1999

Expiration Date

06/30/2002

State

IL

Specialty/Qualifier

Family Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006