CASSIDY RAY LONG DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036138148

License Status

NOT RENEWED

Business

Title

First Name

CASSIDY

Middle

RAY

Last Name

LONG

Business Name

CASSIDY RAY LONG DO

Original Issue Date

06/02/2015

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

GALESBURG

State

Zip

61401

County

KNOX

Ever Disciplined

LastModifiedDate

01/14/2021