DONALD R FORD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

NOT RENEWED

Business

First Name

DONALD R

Last Name

FORD

Suffix

Business Name

DONALD R FORD MD

Original Issue Date

08/26/1987

Effective Date

04/13/2011

Expiration Date

07/31/2014

City

CAMBRIDGE

State

Zip

61238

County

HENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020