ALAN EDWARD LONG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

NOT RENEWED

Business

Title

First Name

ALAN

Middle

EDWARD

Last Name

LONG

Business Name

ALAN EDWARD LONG MD

Original Issue Date

10/27/2017

Effective Date

10/27/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

01/14/2021