CAITLYN SHEA BERG DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070674

License Status

CANCELLED

Business

Title

First Name

CAITLYN

Middle

SHEA

Last Name

BERG

Business Name

CAITLYN SHEA BERG DO

Original Issue Date

06/26/2017

Effective Date

06/26/2017

Expiration Date

06/25/2020

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

04/27/2017