SAMUEL EUGENE LONG Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036037162

License Status

NOT RENEWED

Business

First Name

SAMUEL

Middle

EUGENE

Last Name

LONG

Business Name

SAMUEL EUGENE LONG

Original Issue Date

05/10/1961

Effective Date

05/10/1961

Expiration Date

07/01/1966

City

EMMITSBURG

State

Zip

21727

County

MARYLAND

Ever Disciplined

LastModifiedDate

09/20/2006