SCOTT D LONG Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036091122

License Status

ACTIVE

Business

First Name

SCOTT D

Last Name

LONG

Business Name

SCOTT D LONG

Original Issue Date

07/01/1995

Effective Date

07/14/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62769

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/14/2023