MICHAEL B MOORE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

NOT RENEWED

Business

Title

First Name

MICHAEL

Middle

Last Name

MOORE

Business Name

MICHAEL B MOORE MD

Original Issue Date

10/03/2017

Effective Date

10/03/2017

Expiration Date

09/30/2020

City

CENTREVILLE

State

Zip

62207

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021