MIRANDA LONG Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****74

License Status

ACTIVE

Business

First Name

MIRANDA

Last Name

LONG

Prefix

Business Name

MIRANDA LONG

Original Issue Date

10/17/2017

Effective Date

02/02/2026

Expiration Date

03/01/2028

City

STERLING

State

Zip

61081

County

WHITESIDE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/02/2026