SCOTT D LONG Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

ACTIVE

Business

First Name

SCOTT D

Last Name

LONG

Business Name

SCOTT D LONG

Original Issue Date

03/15/1996

Effective Date

06/23/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62769

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/23/2023