DENISE LEIGH LONG DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019025315

License Status

NOT RENEWED

Business

First Name

DENISE

Middle

LEIGH

Last Name

LONG

Suffix

DMD

Business Name

DENISE LEIGH LONG DMD

Original Issue Date

07/07/2000

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

FAIRVIEW HEIGHTS

State

Zip

62208

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

11/08/2006