CHARLES WILLIAM LONGWELL JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036056601

License Status

NOT RENEWED

Business

Title

First Name

CHARLES

Middle

WILLIAM

Last Name

LONGWELL

Suffix

Business Name

CHARLES WILLIAM LONGWELL JR MD

Original Issue Date

04/13/1978

Effective Date

07/24/2014

Expiration Date

07/31/2017

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

11/01/2017