MARY L MOORE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

NOT RENEWED

Business

First Name

MARY L

Last Name

MOORE

Suffix

Business Name

MARY L MOORE MD

Original Issue Date

05/23/1988

Effective Date

06/05/2008

Expiration Date

07/31/2011

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011