MARK J MOODY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036057451

License Status

NOT RENEWED

Business

First Name

MARK J

Last Name

MOODY

Suffix

Business Name

MARK J MOODY MD

Original Issue Date

08/21/1978

Effective Date

08/21/1978

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006