REBECCA LONG LARK Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125031346

License Status

EXPIRED

Business

First Name

REBECCA

Last Name

LONG LARK

Business Name

REBECCA LONG LARK

Original Issue Date

05/23/1994

Effective Date

05/23/1994

Expiration Date

06/23/1997

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006