DAVID E BERTAGNA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****43

License Status

NOT RENEWED

Business

First Name

DAVID E

Last Name

BERTAGNA

Business Name

DAVID E BERTAGNA

Original Issue Date

11/13/1987

Effective Date

03/16/2022

Expiration Date

09/30/2024

City

CHICAGO

State

Zip

60634

County

COOK

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

02/04/2025