BRIAN EDWARD MOORE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036115598

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

EDWARD

Last Name

MOORE

Suffix

Business Name

BRIAN EDWARD MOORE MD

Original Issue Date

04/03/2006

Effective Date

05/13/2014

Expiration Date

07/31/2017

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Ever Disciplined

LastModifiedDate

11/01/2017