SCOTT R MOORE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****79

License Status

NOT RENEWED

Business

First Name

SCOTT

Middle

Last Name

MOORE

Business Name

SCOTT R MOORE

Original Issue Date

05/23/2007

Effective Date

05/23/2007

Expiration Date

03/01/2008

City

WAUCONDA

State

Zip

60084

County

LAKE

Ever Disciplined

LastModifiedDate

12/16/2010