EDWARD R LONG Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019025972

License Status

NOT RENEWED

Business

First Name

EDWARD

Middle

Last Name

LONG

Business Name

EDWARD R LONG

Original Issue Date

09/18/2002

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

11/08/2006