JUSTIN HALE LONG MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055039

License Status

EXPIRED

Business

Title

First Name

JUSTIN

Middle

HALE

Last Name

LONG

Business Name

JUSTIN HALE LONG MD

Original Issue Date

06/22/2008

Effective Date

06/22/2008

Expiration Date

06/21/2009

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

07/15/2009