RICHARD E LONG MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125016699

License Status

EXPIRED

Business

First Name

RICHARD E

Last Name

LONG

Suffix

Business Name

RICHARD E LONG MD

Original Issue Date

06/01/1984

Effective Date

06/01/1984

Expiration Date

07/01/1986

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006