KENNETH LAWRENCE MOORE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

ACTIVE

Business

First Name

KENNETH

Middle

LAWRENCE

Last Name

MOORE

Suffix

Business Name

KENNETH LAWRENCE MOORE MD

Original Issue Date

10/13/1998

Effective Date

05/07/2023

Expiration Date

07/31/2026

City

BURR RIDGE

State

Zip

60527

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/07/2023