BURT ELMER LONG MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036029234

License Status

INACTIVE

Business

First Name

BURT ELMER

Last Name

LONG

Suffix

Business Name

BURT ELMER LONG MD

Original Issue Date

12/01/1948

Effective Date

12/01/1948

Expiration Date

07/31/1996

City

WHEATON

State

Zip

60187

County

DUPAGE

Ever Disciplined

LastModifiedDate

09/20/2006