JOHN F FORD DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****34

License Status

NOT RENEWED

Business

First Name

JOHN F

Last Name

FORD

Suffix

DDS

Business Name

JOHN F FORD DDS

Original Issue Date

12/03/1996

Effective Date

12/03/1996

Expiration Date

09/30/1998

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005