SAM A MOORE DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036075380

License Status

ACTIVE

Business

First Name

SAM A

Last Name

MOORE

Suffix

Business Name

SAM A MOORE DO

Original Issue Date

07/02/1987

Effective Date

04/18/2023

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

04/18/2023