SCOTT FORREST BERLIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****49

License Status

NOT RENEWED

Business

First Name

SCOTT FORREST

Last Name

BERLIN

Suffix

Business Name

SCOTT FORREST BERLIN MD

Original Issue Date

07/12/1993

Effective Date

07/12/1993

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006