ROBERT WILSON LONG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

NOT RENEWED

Business

First Name

ROBERT WILSON

Last Name

LONG

Suffix

Business Name

ROBERT WILSON LONG MD

Original Issue Date

08/07/1981

Effective Date

08/07/1981

Expiration Date

07/31/1987

City

DIXON

State

Zip

60121

County

LEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006