HEATHER E MOSS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036125684

License Status

NOT RENEWED

Business

First Name

HEATHER

Middle

Last Name

MOSS

Suffix

Business Name

HEATHER E MOSS MD

Original Issue Date

05/05/2010

Effective Date

04/16/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017