EDWARD BRIDGES MOODY MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

INACTIVE

Business

First Name

EDWARD

Middle

BRIDGES

Last Name

MOODY

Suffix

Business Name

EDWARD BRIDGES MOODY MD

Original Issue Date

07/20/1999

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61605

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023