MALLORY M BERG Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****42

License Status

ACTIVE

Business

First Name

MALLORY

Middle

Last Name

BERG

Business Name

MALLORY M BERG

Original Issue Date

06/04/2018

Effective Date

05/07/2024

Expiration Date

05/31/2026

City

PALOS PARK

State

Zip

60464

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026