HEATHER M LONGIN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****16

License Status

NOT RENEWED

Business

First Name

HEATHER

Middle

Last Name

LONGIN

Business Name

HEATHER M LONGIN

Original Issue Date

03/28/2007

Effective Date

06/29/2011

Expiration Date

07/31/2014

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014