LOUISE DOROLEK BERGMAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020002179

License Status

NOT RENEWED

Business

First Name

LOUISE DOROLEK

Last Name

BERGMAN

Business Name

LOUISE DOROLEK BERGMAN

Original Issue Date

07/03/1974

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

LONG GROVE

State

Zip

60047

County

LAKE

Ever Disciplined

LastModifiedDate

11/08/2006