MICHAEL E LONGEVIN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

NOT RENEWED

Business

First Name

MICHAEL E

Last Name

LONGEVIN

Business Name

MICHAEL E LONGEVIN

Original Issue Date

11/24/1986

Effective Date

07/10/2014

Expiration Date

07/31/2017

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017