ANITA L ONG Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

First Name

ANITA L

Last Name

ONG

Business Name

ANITA L ONG

Original Issue Date

09/15/2004

Effective Date

06/12/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60605

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021