WILLIAM JESSE FORD MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067401

License Status

CANCELLED

Business

Title

First Name

WILLIAM

Middle

JESSE

Last Name

FORD

Business Name

WILLIAM JESSE FORD MD

Original Issue Date

06/23/2015

Effective Date

06/23/2015

Expiration Date

06/22/2018

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

06/08/2015