KATHERINE MARY LONG Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008165

License Status

ACTIVE

Business

First Name

KATHERINE

Middle

MARY

Last Name

LONG

Business Name

KATHERINE MARY LONG

Original Issue Date

01/28/2021

Effective Date

02/22/2024

Expiration Date

03/01/2026

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

12/03/2025