DAVID D LONG DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012746

License Status

NOT RENEWED

Business

First Name

DAVID D

Last Name

LONG

Suffix

DDS

Business Name

DAVID D LONG DDS

Original Issue Date

07/15/1965

Effective Date

07/15/1965

Expiration Date

09/30/1994

City

MONMOUTH

State

Zip

61462

County

WARREN

Ever Disciplined

LastModifiedDate

10/12/2005