GLENNETTA MOORE COLEMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

NOT RENEWED

Business

First Name

GLENNETTA MOORE

Last Name

COLEMAN

Suffix

Business Name

GLENNETTA MOORE COLEMAN MD

Original Issue Date

01/25/1988

Effective Date

01/25/1988

Expiration Date

07/31/1993

City

PECATONICA

State

Zip

61063

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020