BETH ALLISON LONGENECKER DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036141672

License Status

NOT RENEWED

Business

Title

First Name

BETH

Middle

ALLISON

Last Name

LONGENECKER

Business Name

BETH ALLISON LONGENECKER DO

Original Issue Date

09/08/2016

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

RIVERSIDE

State

Zip

60546

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021