ANGELIQUE R FORD DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019026718

License Status

NOT RENEWED

Business

First Name

ANGELIQUE

Middle

Last Name

FORD

Suffix

DDS

Business Name

ANGELIQUE R FORD DDS

Original Issue Date

05/13/2005

Effective Date

09/25/2021

Expiration Date

09/30/2024

City

PEORIA

State

Zip

85383

Ever Disciplined

LastModifiedDate

02/04/2025