JACKSON CONNELY MOODY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036031006

License Status

NOT RENEWED

Business

First Name

JACKSON CONNELY

Last Name

MOODY

Suffix

Business Name

JACKSON CONNELY MOODY MD

Original Issue Date

10/04/1951

Effective Date

10/04/1951

Expiration Date

07/31/1987

City

SILVER CITY

State

Zip

88061

County

NEW MEXICO

Ever Disciplined

LastModifiedDate

09/20/2006