VIVIAN F MOYNIHAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

CANCELLED

Business

First Name

VIVIAN F

Last Name

MOYNIHAN

Suffix

Business Name

VIVIAN F MOYNIHAN MD

Original Issue Date

08/24/1988

Effective Date

08/24/1988

Expiration Date

07/31/2005

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006