GLENN M FORD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036064596

License Status

NOT RENEWED

Business

First Name

GLENN

Middle

Last Name

FORD

Suffix

Business Name

GLENN M FORD MD

Original Issue Date

06/28/1982

Effective Date

06/28/1982

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60619

County

COOK

Ever Disciplined

LastModifiedDate

03/10/2010

Case Number

2009004631

Action

Refuse To Renew

Discipline Start Date

07/15/2009

Discipline Reason

due to a sister state discipline.