CEREESA E LONGEST Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

NOT RENEWED

Business

First Name

CEREESA E

Last Name

LONGEST

Business Name

CEREESA E LONGEST

Original Issue Date

03/15/1995

Effective Date

06/11/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

04/05/2020