MARIE L LONG Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

NOT RENEWED

Business

First Name

MARIE L

Last Name

LONG

Business Name

MARIE L LONG

Original Issue Date

09/06/1995

Effective Date

09/06/1995

Expiration Date

07/31/1996

City

DECATUR

State

Zip

62526

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011