OLIVER KENNETH DELONG - Physician Assistant License in Illinois | # 085000535

OLIVER KENNETH DELONG

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000535

License Status

NOT RENEWED

Business

N

First Name

OLIVER

Middle

KENNETH

Last Name

DELONG

Business Name

OLIVER KENNETH DELONG

Original Issue Date

05/12/1993

Effective Date

05/12/1993

Expiration Date

03/01/2004

State

IL

Ever Disciplined

N

LastModifiedDate

10/09/2006