SHAWN RAY LONG - Dentist License in Indiana | # 019025784

SHAWN RAY LONG

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019025784

License Status

NOT RENEWED

Business

N

First Name

SHAWN

Middle

RAY

Last Name

LONG

Business Name

SHAWN RAY LONG

Original Issue Date

03/15/2002

Effective Date

03/15/2002

Expiration Date

09/30/2004

State

IN

Ever Disciplined

N

LastModifiedDate

10/17/2005