JUSTIN BRADLEY LONG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036132063

License Status

NOT RENEWED

Business

Title

First Name

JUSTIN

Middle

BRADLEY

Last Name

LONG

Business Name

JUSTIN BRADLEY LONG MD

Original Issue Date

03/12/2013

Effective Date

04/21/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017