STEPHANIE BLAIR LONG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036159408

License Status

NOT RENEWED

Business

Title

First Name

STEPHANIE

Middle

BLAIR

Last Name

LONG

Business Name

STEPHANIE BLAIR LONG MD

Original Issue Date

02/08/2022

Effective Date

02/08/2022

Expiration Date

07/31/2023

City

PASADENA

State

Zip

91104

Ever Disciplined

LastModifiedDate

11/30/2023