GREGORY DALE LONG DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019031316

License Status

ACTIVE

Business

Title

DMD

First Name

GREGORY

Middle

DALE

Last Name

LONG

Business Name

GREGORY DALE LONG DMD

Original Issue Date

08/02/2017

Effective Date

06/27/2024

Expiration Date

09/30/2027

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

06/27/2024