FRED R MOSS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125022073

License Status

EXPIRED

Business

First Name

FRED

Middle

Last Name

MOSS

Suffix

Business Name

FRED R MOSS MD

Original Issue Date

05/07/1988

Effective Date

05/07/1988

Expiration Date

07/01/1991

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

01/06/2012