ANGELIQUE R FORD DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****59

License Status

NOT RENEWED

Business

First Name

ANGELIQUE

Middle

Last Name

FORD

Suffix

DDS

Business Name

ANGELIQUE R FORD DDS

Original Issue Date

06/17/2005

Effective Date

09/25/2021

Expiration Date

09/30/2024

City

LINCOLNWOOD

State

Zip

60712

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025