ANGELA LONG MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125041427

License Status

EXPIRED

Business

First Name

ANGELA

Last Name

LONG

Suffix

Business Name

ANGELA LONG MD

Original Issue Date

07/01/2000

Effective Date

07/01/2000

Expiration Date

09/30/2003

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006