INGA CHARISSE FORDE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036128277

License Status

NOT RENEWED

Business

Title

First Name

INGA

Middle

CHARISSE

Last Name

FORDE

Business Name

INGA CHARISSE FORDE MD

Original Issue Date

06/29/2011

Effective Date

05/16/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60654

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017