ANGELA GAY BERGSTROM Orthotist, Prosthetist, and Pedorthist License verification

Business Entity

NOT RENEWED

License Type

Orthotist, Prosthetist, and Pedorthist

Description

LICENSED PEDORTHIST

License Number

212000091

License Status

NOT RENEWED

Business

First Name

ANGELA

Middle

GAY

Last Name

BERGSTROM

Business Name

ANGELA GAY BERGSTROM

Original Issue Date

01/31/2002

Effective Date

05/07/2010

Expiration Date

09/30/2011

City

MOUNT MORRIS

State

Zip

61054

County

OGLE

Ever Disciplined

LastModifiedDate

11/04/2011