ALYSSA MARIE UPHOFF BURGART MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

Title

First Name

ALYSSA MARIE

Middle

UPHOFF

Last Name

BURGART

Business Name

ALYSSA MARIE UPHOFF BURGART MD

Original Issue Date

11/01/2012

Effective Date

06/10/2014

Expiration Date

07/31/2017

City

BERWYN

State

Zip

60402

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017