LENA XIAOYU GONG MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056494

License Status

CANCELLED

Business

Title

First Name

LENA

Middle

XIAOYU

Last Name

GONG

Business Name

LENA XIAOYU GONG MD

Original Issue Date

06/24/2011

Effective Date

06/24/2011

Expiration Date

06/23/2014

City

EVANSTON

State

Zip

60201

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/01/2014