KRIEGH P MOULTON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

First Name

KRIEGH P

Last Name

MOULTON

Suffix

Business Name

KRIEGH P MOULTON MD

Original Issue Date

07/30/1991

Effective Date

05/18/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021