DWAYNE LEROY BERGMANN MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036040820

License Status

INACTIVE

Business

First Name

DWAYNE LEROY

Last Name

BERGMANN

Suffix

Business Name

DWAYNE LEROY BERGMANN MD

Original Issue Date

11/28/1966

Effective Date

11/28/1966

Expiration Date

07/31/1987

City

ST. LOUIS

State

Zip

63109

County

MISSOURI

Ever Disciplined

LastModifiedDate

09/20/2006