ANDREW BENJAMIN MOORE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

ACTIVE

Business

Title

First Name

ANDREW

Middle

BENJAMIN

Last Name

MOORE

Business Name

ANDREW BENJAMIN MOORE MD

Original Issue Date

04/11/2017

Effective Date

07/31/2023

Expiration Date

07/31/2026

City

ROANOKE

State

Zip

24014

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/31/2023