CARLY SUZANNE BERG MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

ACTIVE

Business

Title

First Name

CARLY

Middle

SUZANNE

Last Name

BERG

Business Name

CARLY SUZANNE BERG MD

Original Issue Date

07/18/2017

Effective Date

07/13/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60647

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/13/2023