ANGELA GAY BERGSTROM - Orthotist, Prosthetist, and Pedorthist License in Illinois | # 212000091

ANGELA GAY BERGSTROM

Business Entity

NOT RENEWED

License Type

Orthotist, Prosthetist, and Pedorthist

Description

LICENSED PEDORTHIST

License Number

212000091

License Status

NOT RENEWED

Business

N

First Name

ANGELA

Middle

GAY

Last Name

BERGSTROM

Business Name

ANGELA GAY BERGSTROM

Original Issue Date

01/31/2002

Effective Date

05/07/2010

Expiration Date

09/30/2011

State

IL

Ever Disciplined

N

LastModifiedDate

11/04/2011