GORDON H FORD Clinical Psychologist License verification

Business Entity

NOT RENEWED

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071001543

License Status

NOT RENEWED

Business

First Name

GORDON H

Last Name

FORD

Business Name

GORDON H FORD

Original Issue Date

07/13/1972

Effective Date

11/01/2004

Expiration Date

09/30/2004

City

CHATHAM

State

Zip

62629

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/11/2005