DANIEL WILLIAM BERGNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****50

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

WILLIAM

Last Name

BERGNER

Suffix

Business Name

DANIEL WILLIAM BERGNER MD

Original Issue Date

01/28/2009

Effective Date

04/15/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017