BARRY L BERGMAN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019013555

License Status

NOT RENEWED

Business

First Name

BARRY L

Last Name

BERGMAN

Suffix

DDS

Business Name

BARRY L BERGMAN DDS

Original Issue Date

07/14/1969

Effective Date

08/26/2009

Expiration Date

09/30/2012

City

CARLOCK

State

Zip

61725

County

MCLEAN

Ever Disciplined

LastModifiedDate

11/14/2012

Case Number

1986000913

Action

Suspension

Discipline Start Date

07/10/1986

Discipline End Date

06/15/1986