TOMMY EARL MOORE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

NOT RENEWED

Business

First Name

TOMMY

Middle

EARL

Last Name

MOORE

Business Name

TOMMY EARL MOORE

Original Issue Date

01/18/2007

Effective Date

01/18/2007

Expiration Date

07/31/2008

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008