S DAVID MOSS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

CANCELLED

Business

First Name

S DAVID

Last Name

MOSS

Suffix

Business Name

S DAVID MOSS MD

Original Issue Date

08/13/1987

Effective Date

08/13/1987

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006