RICHARD DUANE FORD DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012476

License Status

INACTIVE

Business

First Name

RICHARD DUANE

Last Name

FORD

Suffix

DDS

Business Name

RICHARD DUANE FORD DDS

Original Issue Date

07/14/1964

Effective Date

07/14/1964

Expiration Date

09/30/2004

City

DECATUR

State

Zip

62522

County

MACON

Ever Disciplined

LastModifiedDate

10/17/2005