REBECCA LONG LARK Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036095169

License Status

NOT RENEWED

Business

First Name

REBECCA

Last Name

LONG LARK

Business Name

REBECCA LONG LARK

Original Issue Date

03/28/1997

Effective Date

03/28/1997

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60610

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006