CHAD J LONG MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042962

License Status

EXPIRED

Business

First Name

CHAD

Middle

Last Name

LONG

Suffix

Business Name

CHAD J LONG MD

Original Issue Date

06/24/2001

Effective Date

06/24/2001

Expiration Date

06/23/2004

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006