CHUNLING GONG MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051918

License Status

CANCELLED

Business

First Name

CHUNLING

Last Name

GONG

Suffix

Business Name

CHUNLING GONG MD

Original Issue Date

07/01/2006

Effective Date

07/01/2006

Expiration Date

06/30/2009

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

11/04/2011