BRIAN M BERG DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****48

License Status

NOT RENEWED

Business

First Name

BRIAN M

Last Name

BERG

Suffix

DDS

Business Name

BRIAN M BERG DDS

Original Issue Date

07/25/1997

Effective Date

07/25/1997

Expiration Date

09/30/1998

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005