PHILIP W MOORE DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053266

License Status

EXPIRED

Business

First Name

PHILIP

Middle

Last Name

MOORE

Suffix

Business Name

PHILIP W MOORE DO

Original Issue Date

07/01/2007

Effective Date

07/01/2007

Expiration Date

06/30/2008

City

NORMAL

State

Zip

61761

County

MCLEAN

Specialty/Qualifier

Rotating Internship

Ever Disciplined

LastModifiedDate

07/31/2008