MARY L MOORE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036076421

License Status

NOT RENEWED

Business

First Name

MARY L

Last Name

MOORE

Suffix

Business Name

MARY L MOORE MD

Original Issue Date

12/02/1987

Effective Date

06/05/2008

Expiration Date

07/31/2011

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Ever Disciplined

LastModifiedDate

11/14/2011