NATHAN W MOORE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

NOT RENEWED

Business

Title

First Name

NATHAN

Middle

Last Name

MOORE

Business Name

NATHAN W MOORE MD

Original Issue Date

02/19/2014

Effective Date

05/20/2014

Expiration Date

07/31/2017

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017