RICHARD MARC MOSS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

NOT RENEWED

Business

First Name

RICHARD

Middle

MARC

Last Name

MOSS

Suffix

Business Name

RICHARD MARC MOSS MD

Original Issue Date

12/18/2008

Effective Date

12/18/2008

Expiration Date

07/31/2011

City

LAWRENCEVILLE

State

Zip

62439

County

LAWRENCE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011