LAURA M MOODY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

NOT RENEWED

Business

First Name

LAURA M

Last Name

MOODY

Suffix

Business Name

LAURA M MOODY MD

Original Issue Date

11/16/1984

Effective Date

11/16/1984

Expiration Date

07/31/1987

City

EAST ST LOUIS

State

Zip

62203

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006