License holder summary

Russell Moore is a Physician licensed to practice in Indiana. The address on file for Russell Moore is Washington DC 20036. This licensed professional license is not current. The license was granted 04/21/2004 and expired on 06/30/2007.

Indiana

Professional Licensing Agency

Russell Moore
Physician
License number
01058998A
Date granted
04/21/2004
Date expires
06/30/2007
Class
Physician
Status
Expired Non-Renewable
Address
Washington DC 20036
indianalicensing.org
ID 6110086
LAST UPDATED 2024-02-12 16:24:28 UTC

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