JESSE MOSS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

Title

First Name

JESSE

Last Name

MOSS

Business Name

JESSE MOSS MD

Original Issue Date

02/23/2021

Effective Date

02/23/2021

Expiration Date

07/31/2023

City

NORMAL

State

Zip

61761

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023