JASON ALLAN BERGANDI Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036114114

License Status

NOT RENEWED

Business

First Name

JASON

Middle

ALLAN

Last Name

BERGANDI

Business Name

JASON ALLAN BERGANDI

Original Issue Date

07/06/2005

Effective Date

04/13/2011

Expiration Date

07/31/2014

City

PERU

State

Zip

61354

County

LA SALLE

Ever Disciplined

LastModifiedDate

11/17/2014

Case Number

2007008826

Action

Suspension

Discipline Start Date

05/08/2012

Discipline Reason

for failure to comply with terms and conditions of agreement with Department.