LA MAR R FORD MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125014938

License Status

EXPIRED

Business

First Name

LA MAR R

Last Name

FORD

Suffix

Business Name

LA MAR R FORD MD

Original Issue Date

08/23/1982

Effective Date

08/23/1982

Expiration Date

06/30/1984

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006