BRIAN NEAL MOSS DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036113994

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

NEAL

Last Name

MOSS

Suffix

Business Name

BRIAN NEAL MOSS DO

Original Issue Date

06/24/2005

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

11/06/2008