KIM A BERGNER Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125030920

License Status

EXPIRED

Business

First Name

KIM A

Last Name

BERGNER

Business Name

KIM A BERGNER

Original Issue Date

05/02/1994

Effective Date

05/02/1994

Expiration Date

06/19/1997

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

10/23/2006