GREGORY DALE LONG DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021003022

License Status

ACTIVE

Business

Title

DMD

First Name

GREGORY

Middle

DALE

Last Name

LONG

Business Name

GREGORY DALE LONG DMD

Original Issue Date

02/05/2020

Effective Date

06/27/2024

Expiration Date

09/30/2027

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS

Ever Disciplined

LastModifiedDate

06/27/2024