SHAWN RAY LONG Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019025784

License Status

NOT RENEWED

Business

First Name

SHAWN

Middle

RAY

Last Name

LONG

Business Name

SHAWN RAY LONG

Original Issue Date

03/15/2002

Effective Date

03/15/2002

Expiration Date

09/30/2004

City

GRANGER

State

Zip

46530

County

INDIANA

Ever Disciplined

LastModifiedDate

10/17/2005