JUSTIN MATTHEW LONG MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036155015

License Status

ACTIVE

Business

Title

First Name

JUSTIN

Middle

MATTHEW

Last Name

LONG

Business Name

JUSTIN MATTHEW LONG MD

Original Issue Date

12/11/2020

Effective Date

06/16/2023

Expiration Date

07/31/2026

City

SAINT LOUIS

State

Zip

63110

Ever Disciplined

LastModifiedDate

06/16/2023