TIMOTHY M. FORD MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130001392

License Status

EXPIRED

Business

Title

First Name

TIMOTHY

Middle

Last Name

FORD

Business Name

TIMOTHY M. FORD MD

Original Issue Date

05/31/2021

Effective Date

05/31/2021

Expiration Date

11/30/2021

City

CHICAGO

State

Zip

60611

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

10/11/2022