DAVID A BERGQUIST MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

NOT RENEWED

Business

Title

First Name

DAVID

Middle

Last Name

BERGQUIST

Business Name

DAVID A BERGQUIST MD

Original Issue Date

05/11/2005

Effective Date

05/11/2005

Expiration Date

07/31/2008

City

HINSDALE

State

Zip

60521

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020