SARAH BETH LONG Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****80

License Status

NOT RENEWED

Business

First Name

SARAH

Middle

BETH

Last Name

LONG

Business Name

SARAH BETH LONG

Original Issue Date

08/24/2006

Effective Date

02/22/2018

Expiration Date

03/01/2020

City

ELK GROVE VILLAGE

State

Zip

60007

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020