DOUGLAS M LONG Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125029848

License Status

EXPIRED

Business

First Name

DOUGLAS

Middle

Last Name

LONG

Business Name

DOUGLAS M LONG

Original Issue Date

05/25/1993

Effective Date

05/25/1993

Expiration Date

06/22/1997

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

09/22/2006