BETH A BERGMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

NOT RENEWED

Business

First Name

BETH A

Last Name

BERGMAN

Suffix

Business Name

BETH A BERGMAN MD

Original Issue Date

09/19/1990

Effective Date

09/19/1990

Expiration Date

07/31/1993

City

SPRINGFIELD

State

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020