MARCIA MONROE MOORE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

CANCELLED

Business

First Name

MARCIA

Middle

MONROE

Last Name

MOORE

Suffix

Business Name

MARCIA MONROE MOORE MD

Original Issue Date

12/05/2003

Effective Date

12/05/2003

Expiration Date

07/31/2008

City

ZION

State

Zip

60099

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008