LISA MAE MOSCOSO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

ACTIVE

Business

Title

First Name

LISA

Middle

MAE

Last Name

MOSCOSO

Business Name

LISA MAE MOSCOSO MD

Original Issue Date

02/20/2018

Effective Date

07/13/2023

Expiration Date

07/31/2026

City

SHILOH

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/13/2023