RICHARD MAURITZ BERGENSTAL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036055078

License Status

NOT RENEWED

Business

First Name

RICHARD MAURITZ

Last Name

BERGENSTAL

Suffix

Business Name

RICHARD MAURITZ BERGENSTAL MD

Original Issue Date

07/18/1977

Effective Date

07/18/1977

Expiration Date

07/31/1984

City

CHICAGO

State

Zip

60615

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006