PATRICK LONG MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075843

License Status

CANCELLED

Business

Title

First Name

PATRICK

Last Name

LONG

Business Name

PATRICK LONG MD

Original Issue Date

06/26/2020

Effective Date

06/26/2020

Expiration Date

06/25/2023

City

HERSCHER

State

Zip

60941

County

KANKAKEE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/20/2020