OLIVER KENNETH DELONG Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000535

License Status

NOT RENEWED

Business

First Name

OLIVER

Middle

KENNETH

Last Name

DELONG

Business Name

OLIVER KENNETH DELONG

Original Issue Date

05/12/1993

Effective Date

05/12/1993

Expiration Date

03/01/2004

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/09/2006