MARY ELLEN MOORE DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

ACTIVE

Business

Title

First Name

MARY

Middle

ELLEN

Last Name

MOORE

Business Name

MARY ELLEN MOORE DO

Original Issue Date

11/25/2014

Effective Date

07/18/2023

Expiration Date

07/31/2026

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/18/2023