DAVID C MOOTH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036093809

License Status

ACTIVE

Business

First Name

DAVID C

Last Name

MOOTH

Suffix

Business Name

DAVID C MOOTH MD

Original Issue Date

07/27/1996

Effective Date

04/13/2023

Expiration Date

07/31/2026

City

CARLYLE

State

Zip

62231

County

CLINTON

Ever Disciplined

LastModifiedDate

04/13/2023

Case Number

2017011237

Action

Suspension

Discipline Start Date

02/02/2018

Discipline End Date

02/16/2018

Discipline Reason

Failure to file and/or pay Illinois state income taxes. Notice of tax deficiency release received from Department of Revenue on 02/20/2018.