GARY WILLIAM LONG DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019015883

License Status

NOT RENEWED

Business

First Name

GARY WILLIAM

Last Name

LONG

Suffix

DDS

Business Name

GARY WILLIAM LONG DDS

Original Issue Date

06/09/1977

Effective Date

06/15/2018

Expiration Date

01/31/2022

City

MORTON

State

Zip

61550

County

TAZEWELL

Ever Disciplined

LastModifiedDate

05/09/2022