BRIAN NEAL MOSS DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

NEAL

Last Name

MOSS

Suffix

Business Name

BRIAN NEAL MOSS DO

Original Issue Date

06/28/2005

Effective Date

06/28/2005

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008