KYLE T BERGAN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****49

License Status

ACTIVE

Business

First Name

KYLE

Middle

Last Name

BERGAN

Business Name

KYLE T BERGAN

Original Issue Date

10/20/2022

Effective Date

03/12/2024

Expiration Date

05/31/2026

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026