JEFFERY D LONG MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125019868

License Status

EXPIRED

Business

Title

First Name

JEFFERY

Middle

Last Name

LONG

Business Name

JEFFERY D LONG MD

Original Issue Date

06/26/1986

Effective Date

06/26/1986

Expiration Date

07/01/1989

City

PEORIA

State

Zip

61636

County

PEORIA

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006