ROBERT PHILLIP LONG DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065090

License Status

CANCELLED

Business

Title

First Name

ROBERT

Middle

PHILLIP

Last Name

LONG

Business Name

ROBERT PHILLIP LONG DO

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

06/30/2017

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

06/09/2014