SCOTT R MOORE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002845

License Status

NOT RENEWED

Business

First Name

SCOTT

Middle

Last Name

MOORE

Business Name

SCOTT R MOORE

Original Issue Date

10/12/2006

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

HAINESVILLE

State

Zip

60030

County

LAKE

Ever Disciplined

LastModifiedDate

04/01/2010