CHARLES RICHARD BERG DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****54

License Status

NOT RENEWED

Business

First Name

CHARLES RICHARD

Last Name

BERG

Suffix

DDS

Business Name

CHARLES RICHARD BERG DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1998

City

LA GRANGE

State

Zip

60525

County

COOK

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

10/17/2005