SUE ANN MOORE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

NOT RENEWED

Business

First Name

SUE

Middle

ANN

Last Name

MOORE

Suffix

Business Name

SUE ANN MOORE MD

Original Issue Date

02/28/2013

Effective Date

05/24/2017

Expiration Date

09/30/2020

City

MARYVILLE

State

Zip

62062

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021