JEAN ELIZABETH MOFFAT MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

CANCELLED

Business

First Name

JEAN ELIZABETH

Last Name

MOFFAT

Suffix

Business Name

JEAN ELIZABETH MOFFAT MD

Original Issue Date

05/12/1983

Effective Date

05/12/1983

Expiration Date

07/31/1990

City

HINES

State

Zip

60141

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006