JAMES THOMAS FORD, IV MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074030

License Status

CANCELLED

Business

Title

First Name

JAMES

Middle

THOMAS

Last Name

FORD, IV

Business Name

JAMES THOMAS FORD, IV MD

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2022

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Interventional Radiology - Integrated

Ever Disciplined

LastModifiedDate

04/24/2020