GLENNETTA MOORE COLEMAN 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

First Name

GLENNETTA MOORE

Last Name

COLEMAN

Suffix

Business Name

GLENNETTA MOORE COLEMAN MD

Original Issue Date

11/08/1983

Effective Date

07/21/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61112

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/21/2023