BENJAMIN DANIEL LONG MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036167191

License Status

ACTIVE

Business

Title

First Name

BENJAMIN

Middle

DANIEL

Last Name

LONG

Business Name

BENJAMIN DANIEL LONG MD

Original Issue Date

09/27/2023

Effective Date

09/27/2023

Expiration Date

07/31/2026

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

02/05/2024