FRED R MOSS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036129270

License Status

NOT RENEWED

Business

First Name

FRED

Middle

Last Name

MOSS

Suffix

Business Name

FRED R MOSS MD

Original Issue Date

11/23/2011

Effective Date

07/19/2017

Expiration Date

09/30/2020

City

OHIO

State

Zip

61349

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

01/14/2021

Case Number

2011010044

Action

Reprimand

Discipline Start Date

11/23/2011

Discipline Reason

due to history of discipline by the Medical Licensing Board of Indiana after disclosure of DUI Misdemeanor in Ohio.