MARK F MOORE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

CANCELLED

Business

First Name

MARK F

Last Name

MOORE

Suffix

Business Name

MARK F MOORE MD

Original Issue Date

06/11/1992

Effective Date

06/11/1992

Expiration Date

07/31/2008

City

GALENA

State

Zip

61036

County

JO DAVIESS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008