G RICHARD LONG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036065007

License Status

NOT RENEWED

Business

First Name

G RICHARD

Last Name

LONG

Suffix

Business Name

G RICHARD LONG MD

Original Issue Date

07/30/1982

Effective Date

07/30/1982

Expiration Date

07/31/1984

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006