LESLIE ANN DIGNAN-MOORE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049030

License Status

CANCELLED

Business

First Name

LESLIE

Middle

ANN

Last Name

DIGNAN-MOORE

Suffix

Business Name

LESLIE ANN DIGNAN-MOORE MD

Original Issue Date

06/24/2005

Effective Date

06/24/2005

Expiration Date

06/23/2008

City

SPRINGFIELD

State

Zip

62702

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006