PATRICK LONG MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

ACTIVE

Business

Title

First Name

PATRICK

Last Name

LONG

Business Name

PATRICK LONG MD

Original Issue Date

03/21/2023

Effective Date

06/01/2023

Expiration Date

07/31/2026

City

HERSCHER

State

Zip

60941

County

KANKAKEE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/01/2023