JUSTIN ROSS MOORE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

NOT RENEWED

Business

Title

First Name

JUSTIN

Middle

ROSS

Last Name

MOORE

Business Name

JUSTIN ROSS MOORE MD

Original Issue Date

07/26/2022

Effective Date

07/26/2022

Expiration Date

07/31/2023

City

DECATUR

State

Zip

62521

County

MACON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023