APIWAT W FORD DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

ACTIVE

Business

First Name

APIWAT W

Last Name

FORD

Suffix

Business Name

APIWAT W FORD DO

Original Issue Date

02/05/1991

Effective Date

07/06/2023

Expiration Date

07/31/2026

City

SAINT CHARLES

State

Zip

60175

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/06/2023