DAVID ANTONIO LONG MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

ACTIVE

Business

Title

First Name

DAVID

Middle

ANTONIO

Last Name

LONG

Business Name

DAVID ANTONIO LONG MD

Original Issue Date

08/03/2017

Effective Date

07/20/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60653

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/20/2023