JUSTIN MATTHEW LONG MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

ACTIVE

Business

Title

First Name

JUSTIN

Middle

MATTHEW

Last Name

LONG

Business Name

JUSTIN MATTHEW LONG MD

Original Issue Date

12/15/2020

Effective Date

06/16/2023

Expiration Date

07/31/2026

City

SAINT LOUIS

State

Zip

63110

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/16/2023