LACEY DIVELY MOY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036129248

License Status

ACTIVE

Business

Title

First Name

LACEY

Middle

DIVELY

Last Name

MOY

Business Name

LACEY DIVELY MOY MD

Original Issue Date

11/17/2011

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Ever Disciplined

LastModifiedDate

04/08/2023