ELIZABETH D MOORE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000386

License Status

NOT RENEWED

Business

First Name

ELIZABETH D

Last Name

MOORE

Business Name

ELIZABETH D MOORE

Original Issue Date

06/27/1989

Effective Date

12/19/2011

Expiration Date

03/01/2014

City

MORTON

State

Zip

61550

County

TAZEWELL

Ever Disciplined

LastModifiedDate

04/08/2014