KIM A BERGNER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036093609

License Status

NOT RENEWED

Business

First Name

KIM A

Last Name

BERGNER

Business Name

KIM A BERGNER

Original Issue Date

07/16/1996

Effective Date

07/16/1996

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006