THERESA ADELAIDE LONGO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036128529

License Status

NOT RENEWED

Business

Title

First Name

THERESA

Middle

ADELAIDE

Last Name

LONGO

Business Name

THERESA ADELAIDE LONGO MD

Original Issue Date

07/15/2011

Effective Date

05/14/2014

Expiration Date

07/31/2017

City

RIVERSIDE

State

Zip

92504

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

11/01/2017