KENNETH LAWRENCE MOORE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036053328

License Status

ACTIVE

Business

First Name

KENNETH

Middle

LAWRENCE

Last Name

MOORE

Suffix

Business Name

KENNETH LAWRENCE MOORE MD

Original Issue Date

08/19/1976

Effective Date

05/07/2023

Expiration Date

07/31/2026

City

BURR RIDGE

State

Zip

60527

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/07/2023

Case Number

2003008638

Action

Probation

Discipline Start Date

02/24/2005

Discipline End Date

01/28/2009