CHARLES D FORD MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125017369

License Status

EXPIRED

Business

First Name

CHARLES D

Last Name

FORD

Suffix

Business Name

CHARLES D FORD MD

Original Issue Date

06/26/1984

Effective Date

06/26/1984

Expiration Date

07/01/1986

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006