MELINDA BETH MOORE DPM Podiatrist License verification

Business Entity

CANCELLED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****03

License Status

CANCELLED

Business

Title

DPM

First Name

MELINDA

Middle

BETH

Last Name

MOORE

Business Name

MELINDA BETH MOORE DPM

Original Issue Date

01/20/2011

Effective Date

01/20/2011

Expiration Date

01/31/2013

City

HERRIN

State

Zip

62948

County

WILLIAMSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/20/2011