DESHON TARIQ MOORE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

ACTIVE

Business

Title

First Name

DESHON

Middle

TARIQ

Last Name

MOORE

Business Name

DESHON TARIQ MOORE MD

Original Issue Date

03/28/2013

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

HAZEL CREST

State

Zip

60429

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2023