VANESSA RENILDE FORD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

NOT RENEWED

Business

Title

First Name

VANESSA

Middle

RENILDE

Last Name

FORD

Business Name

VANESSA RENILDE FORD MD

Original Issue Date

03/28/2022

Effective Date

03/28/2022

Expiration Date

07/31/2023

City

DECATUR

State

Zip

30030

County

DEKALB

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023