Wallace Dale Long

License

Licensed by

Illinois Department of Financial and Professional Regulation

License number

019010871

Status

Expired (Not Renewed)

First issued

August 14, 1956

Expired

September 30, 1994

License holder

Wallace Dale Long

Entity type

Individual

Classifications

• Licensed Dentist (Dental) Dental

More from the license record

Current term began

08/14/1956

Other Illinois licenses under this name

• IL
  Wallace Dale Long

  License 31*****72

  Licensed Dentist Controlled Substance (Dental)
  Expired

  Decatur, IL

  Expired Sep 30, 1994

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