License holder summary

Roger T. Moore is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Roger T. Moore is Advanced Dermatology of Northern Indiana, 111 N. Nappanee Street, Elkhart IN 46514. This licensed professional license is current. The license was granted 01/20/2004 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Roger T. Moore
Controlled Substance Registration - Physician
License number
01058554B
Date granted
01/20/2004
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Advanced Dermatology of Northern Indiana, 111 N. Nappanee Street, Elkhart IN 46514
indianalicensing.org
ID 5848301
LAST UPDATED 2024-04-10 20:27:49 UTC

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