STEPHANIE RENEE LONG DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****08

License Status

ACTIVE

Business

Title

DMD

First Name

STEPHANIE

Middle

RENEE

Last Name

LONG

Business Name

STEPHANIE RENEE LONG DMD

Original Issue Date

07/14/2009

Effective Date

10/01/2024

Expiration Date

09/30/2027

City

HIGHLAND

State

Zip

62249

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/16/2024