WILLIAM T LONG Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125019121

License Status

EXPIRED

Business

First Name

WILLIAM

Middle

Last Name

LONG

Business Name

WILLIAM T LONG

Original Issue Date

03/12/1986

Effective Date

03/12/1986

Expiration Date

03/04/1989

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006