FLETCHER BRADY MOORE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****67

License Status

ACTIVE

Business

Title

First Name

FLETCHER

Middle

BRADY

Last Name

MOORE

Business Name

FLETCHER BRADY MOORE MD

Original Issue Date

07/02/2021

Effective Date

06/29/2023

Expiration Date

07/31/2026

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/29/2023