ELIZABETH D MOORE Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****76

License Status

INOPERATIVE

Business

First Name

ELIZABETH D

Last Name

MOORE

Business Name

ELIZABETH D MOORE

Original Issue Date

09/07/2001

Effective Date

02/17/2012

Expiration Date

03/01/2014

City

MORTON

State

Zip

61550

County

TAZEWELL

Ever Disciplined

LastModifiedDate

11/05/2013