Field Name · Applicant
Italic names are derived; accent values differ from the applicant’s prior license.
| Applicant Type | I - Individual |
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| Entity Type | L - Licensee or Assignee |
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| Entity Name | BERGSTROM, THEODORE A |
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| Attention | |
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| First Name / Middle Init / Last Name / Name Suffix | THEODORE A BERGSTROM |
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| Street Address | 50 Bayshore Drive |
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| Po Box | |
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| Locality | Mashpee |
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| County | Barnstable County |
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| State | MA - Massachusetts |
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| Postal Code | 02649 |
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| Zip Location | 41°37'00.5"N 70°29'24.3"W |
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| Maidenhead | FN41so |
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| FRN | 0003643632 |
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| Geo Region | 1 / MA |
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| Licensee ID/SGIN | L00159661 / 000 |
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| Callsign | W1IQW |
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| Last Action Date | 2001-07-24 |
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| Radio Service | HA - Amateur |
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| App Purpose | AU - Administrative Update |
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| App Source | I - Online |
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| App Status | G - Granted |
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| Entered Timestamp | 2001-07-23 |
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| Fee Control Num | |
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| Orig Purpose | |
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| Receipt Date | Mon 2001-07-23 |
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| Payment Date | |
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| Is From Vec | |
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| Is Trustee | |
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| Operator Group | |
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| Licensee Class | |
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| New Seq Callsign | |
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| Trustee Callsign | |
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| Trustee Name | |
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| ULS Group / ULS Region | / |
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| Prev Callsign / Prev Class | |
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| Vanity Relationship | |
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| Vanity Type | |
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| Fee Exempt / Waiver | / |
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