ROBERT W LONG DO

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****16

NOT RENEWED

N

ROBERT W

LONG

DO

ROBERT W LONG DO

08/26/1987

08/26/1987

07/31/1996

ADDISON

IL

60101

DUPAGE

II III IV V

N

04/05/2020