THOMAS PAUL FORD DMD Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****71

License Status

CANCELLED

Business

First Name

THOMAS PAUL

Last Name

FORD

Suffix

DMD

Business Name

THOMAS PAUL FORD DMD

Original Issue Date

10/21/1988

Effective Date

10/21/1988

Expiration Date

09/30/1992

City

MASON CITY

State

Zip

62664

County

MASON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005