WYNTRIA DONELLE LACABE-MOORE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

NOT RENEWED

Business

Title

First Name

WYNTRIA

Middle

DONELLE

Last Name

LACABE-MOORE

Business Name

WYNTRIA DONELLE LACABE-MOORE MD

Original Issue Date

03/13/2014

Effective Date

03/13/2014

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

11/17/2014