SUSAN ANN BERG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

NOT RENEWED

Business

Title

First Name

SUSAN

Middle

ANN

Last Name

BERG

Business Name

SUSAN ANN BERG MD

Original Issue Date

10/16/2013

Effective Date

06/12/2014

Expiration Date

07/31/2017

City

HOOPESTON

State

Zip

60942

County

VERMILION

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017