MOIRA TERESE PRUETT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

NOT RENEWED

Business

First Name

MOIRA

Middle

TERESE

Last Name

PRUETT

Suffix

Business Name

MOIRA TERESE PRUETT MD

Original Issue Date

02/20/1986

Effective Date

02/20/1986

Expiration Date

07/31/1987

City

EVANSTON

State

Zip

60202

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006