MELISSA ANN BERGSTROM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

NOT RENEWED

Business

First Name

MELISSA

Middle

ANN

Last Name

BERGSTROM

Suffix

Business Name

MELISSA ANN BERGSTROM MD

Original Issue Date

02/07/2002

Effective Date

02/07/2002

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008