LAURA LYNN LONG MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046007

License Status

CANCELLED

Business

First Name

LAURA

Middle

LYNN

Last Name

LONG

Suffix

Business Name

LAURA LYNN LONG MD

Original Issue Date

06/17/2003

Effective Date

06/17/2003

Expiration Date

06/16/2006

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006