ZACHARY JAMES LONG MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072182

License Status

CANCELLED

Business

Title

First Name

ZACHARY

Middle

JAMES

Last Name

LONG

Business Name

ZACHARY JAMES LONG MD

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2021

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/17/2018