The holder whose full name is LONG, DALE EVONNE,come from Lewisburg KY,hold the CSR-Osteopathic Physician license(NO.02001408B) which status is Expired.
| Name | LONG, DALE EVONNE |
|---|---|
| License Number | 02001408B |
| License Type | CSR-Osteopathic Physician |
| License Status | Expired |
| City | Lewisburg |
| State | KY |