MARY ALICE BERGER Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

CANCELLED

Business

First Name

MARY

Middle

ALICE

Last Name

BERGER

Business Name

MARY ALICE BERGER

Original Issue Date

02/28/2002

Effective Date

02/28/2002

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011