THOMAS PAUL FORD DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****70

License Status

NOT RENEWED

Business

First Name

THOMAS PAUL

Last Name

FORD

Suffix

DMD

Business Name

THOMAS PAUL FORD DMD

Original Issue Date

01/01/1998

Effective Date

06/25/2018

Expiration Date

01/31/2022

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022