NICHOLAS HANNUM VON BERGEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036141440

License Status

ACTIVE

Business

Title

First Name

NICHOLAS

Middle

HANNUM

Last Name

VON BERGEN

Business Name

NICHOLAS HANNUM VON BERGEN MD

Original Issue Date

08/08/2016

Effective Date

05/17/2023

Expiration Date

07/31/2026

City

MIDDLETON

State

Zip

53562

Ever Disciplined

LastModifiedDate

05/17/2023