ANGELA LONG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

NOT RENEWED

Business

First Name

ANGELA

Last Name

LONG

Suffix

Business Name

ANGELA LONG MD

Original Issue Date

07/10/2003

Effective Date

07/10/2003

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020