ERIC E E MOUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

NOT RENEWED

Business

First Name

ERIC E E

Last Name

MOUM

Suffix

Business Name

ERIC E E MOUM MD

Original Issue Date

11/08/1983

Effective Date

11/08/1983

Expiration Date

07/31/1984

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006