KATIE KIMBERLY LONGO MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125066188

License Status

EXPIRED

Business

Title

First Name

KATIE

Middle

KIMBERLY

Last Name

LONGO

Business Name

KATIE KIMBERLY LONGO MD

Original Issue Date

06/24/2015

Effective Date

06/24/2015

Expiration Date

06/23/2018

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/25/2018