DEANNE LONG Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036100813

License Status

NOT RENEWED

Business

First Name

DEANNE

Last Name

LONG

Business Name

DEANNE LONG

Original Issue Date

07/28/1999

Effective Date

07/28/1999

Expiration Date

07/31/2002

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Ever Disciplined

LastModifiedDate

04/17/2015

Case Number

2015001583

Action

Refuse To Renew

Discipline Start Date

04/07/2015

Discipline Reason

for sister state discipline in the State of Utah.