THERESA ADELAIDE LONGO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

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

07/15/2011

Expiration Date

07/31/2014

City

DELANO

State

Zip

93216

County

CALIFORNIA

Specialty/Qualifier

PRACTITIONER

Ever Disciplined

LastModifiedDate

04/12/2017