MADELINE POLONIA LONG - Clinical Psychologist License in Illinois | # 071006212

MADELINE POLONIA LONG

Business Entity

NOT RENEWED

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071006212

License Status

NOT RENEWED

Business

N

First Name

MADELINE

Middle

POLONIA

Last Name

LONG

Business Name

MADELINE POLONIA LONG

Original Issue Date

01/29/2001

Effective Date

10/15/2002

Expiration Date

09/30/2002

State

IL

Ever Disciplined

N

LastModifiedDate

09/11/2005