THOMAS FORDHAM WILSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

ACTIVE

Business

Title

First Name

THOMAS

Middle

FORDHAM

Last Name

WILSON

Business Name

THOMAS FORDHAM WILSON MD

Original Issue Date

09/04/2024

Effective Date

09/04/2024

Expiration Date

07/31/2026

City

DECATUR

State

Zip

62526

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/04/2024