FANNY J BERG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****60

License Status

NOT RENEWED

Business

First Name

FANNY J

Last Name

BERG

Suffix

Business Name

FANNY J BERG MD

Original Issue Date

08/25/1983

Effective Date

08/25/1983

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006