SUE ANN MOORE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036122930

License Status

NOT RENEWED

Business

First Name

SUE

Middle

ANN

Last Name

MOORE

Suffix

Business Name

SUE ANN MOORE MD

Original Issue Date

03/26/2009

Effective Date

05/23/2017

Expiration Date

09/30/2020

City

MARYVILLE

State

Zip

62062

County

MADISON

Ever Disciplined

LastModifiedDate

01/14/2021