SCOTT D LONG Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027928

License Status

EXPIRED

Business

First Name

SCOTT D

Last Name

LONG

Business Name

SCOTT D LONG

Original Issue Date

05/06/1992

Effective Date

05/06/1992

Expiration Date

06/30/1995

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/22/2006