BETH MARA MARSHALL-BERGMAN DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

ACTIVE

Business

Title

First Name

BETH

Middle

MARA

Last Name

MARSHALL-BERGMAN

Business Name

BETH MARA MARSHALL-BERGMAN DO

Original Issue Date

06/25/2014

Effective Date

07/15/2023

Expiration Date

07/31/2026

City

OAK PARK

State

Zip

60304

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/15/2023