WILLARD D MOORE JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036050851

License Status

NOT RENEWED

Business

First Name

WILLARD D

Last Name

MOORE JR

Suffix

Business Name

WILLARD D MOORE JR MD

Original Issue Date

03/21/1975

Effective Date

04/24/2014

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/01/2017