GERNON MATTHEW LONGO MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045491

License Status

EXPIRED

Business

First Name

GERNON

Middle

MATTHEW

Last Name

LONGO

Suffix

Business Name

GERNON MATTHEW LONGO MD

Original Issue Date

07/01/2003

Effective Date

07/01/2003

Expiration Date

06/30/2005

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Vascular Surgery

Ever Disciplined

LastModifiedDate

09/22/2006