CHARLES WILLIAM LONGWELL JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

NOT RENEWED

Business

Title

First Name

CHARLES

Middle

WILLIAM

Last Name

LONGWELL

Suffix

Business Name

CHARLES WILLIAM LONGWELL JR MD

Original Issue Date

01/01/1997

Effective Date

07/24/2014

Expiration Date

07/31/2017

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017