ANGELA LONG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

NOT RENEWED

Business

First Name

ANGELA

Last Name

LONG

Suffix

Business Name

ANGELA LONG MD

Original Issue Date

10/09/2007

Effective Date

06/16/2008

Expiration Date

07/31/2011

City

JOLIET

State

Zip

60434

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020