THOMAS J LONGOS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****19

License Status

ACTIVE

Business

First Name

THOMAS J

Last Name

LONGOS

Business Name

THOMAS J LONGOS

Original Issue Date

03/05/2001

Effective Date

05/29/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/29/2024