ANIT D FORD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

NOT RENEWED

Business

First Name

ANIT D

Last Name

FORD

Suffix

Business Name

ANIT D FORD MD

Original Issue Date

09/29/1989

Effective Date

09/29/1989

Expiration Date

07/31/1993

City

TSAILE

State

Zip

86556

County

ARIZONA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017