LAWRENCE ALBERT BERGMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

NOT RENEWED

Business

First Name

LAWRENCE ALBERT

Last Name

BERGMAN

Suffix

Business Name

LAWRENCE ALBERT BERGMAN MD

Original Issue Date

08/05/2005

Effective Date

04/25/2011

Expiration Date

07/31/2014

City

ELK GROVE VILLAGE

State

Zip

60007

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020