TIMOTHY J LONG Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036094444

License Status

ACTIVE

Business

First Name

TIMOTHY J

Last Name

LONG

Business Name

TIMOTHY J LONG

Original Issue Date

10/24/1996

Effective Date

05/27/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60610

County

COOK

Ever Disciplined

LastModifiedDate

05/27/2023