BURTON EMERSON MOORE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

CANCELLED

Business

First Name

BURTON

Middle

EMERSON

Last Name

MOORE

Suffix

Business Name

BURTON EMERSON MOORE MD

Original Issue Date

01/01/1997

Effective Date

07/23/2008

Expiration Date

07/31/2011

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011