D GAIL BERGER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****88

License Status

NOT RENEWED

Business

First Name

D GAIL

Last Name

BERGER

Business Name

D GAIL BERGER

Original Issue Date

09/29/1989

Effective Date

09/29/1989

Expiration Date

09/30/1990

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005