DELORA L MOUNT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****82

License Status

NOT RENEWED

Business

Title

First Name

DELORA

Middle

Last Name

MOUNT

Business Name

DELORA L MOUNT MD

Original Issue Date

05/28/2013

Effective Date

06/12/2020

Expiration Date

07/31/2023

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023