RICHARD A MOORE OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****04

License Status

CANCELLED

Business

First Name

RICHARD

Middle

Last Name

MOORE

Suffix

Business Name

RICHARD A MOORE OD

Original Issue Date

11/02/1999

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

MONMOUTH

State

Zip

61462

County

WARREN

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

04/09/2008