COREY D MOOD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****48

License Status

NOT RENEWED

Business

First Name

COREY

Middle

Last Name

MOOD

Business Name

COREY D MOOD

Original Issue Date

11/01/2006

Effective Date

01/05/2010

Expiration Date

03/01/2012

City

MORTON GROVE

State

Zip

60053

County

COOK

Ever Disciplined

LastModifiedDate

04/16/2012