JENNIFER L BERGQUIST Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

ACTIVE

Business

First Name

JENNIFER

Middle

Last Name

BERGQUIST

Business Name

JENNIFER L BERGQUIST

Original Issue Date

07/01/2005

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60642

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2023