MARIE L LONG Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

NOT RENEWED

Business

First Name

MARIE L

Last Name

LONG

Business Name

MARIE L LONG

Original Issue Date

09/01/1995

Effective Date

07/08/2008

Expiration Date

07/31/2011

City

DECATUR

State

Zip

62526

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011