DEBORAH LEE BERGMAN Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****02

License Status

NOT RENEWED

Business

First Name

DEBORAH LEE

Last Name

BERGMAN

Business Name

DEBORAH LEE BERGMAN

Original Issue Date

01/24/2003

Effective Date

03/16/2020

Expiration Date

08/31/2022

City

CHICAGO

State

Zip

60611

County

COOK

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

10/14/2022