BENERANDA S FORD-GLANTON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

NOT RENEWED

Business

Title

First Name

BENERANDA

Middle

Last Name

FORD-GLANTON

Business Name

BENERANDA S FORD-GLANTON MD

Original Issue Date

07/24/2007

Effective Date

06/09/2017

Expiration Date

09/30/2020

City

BELLEVILLE

State

Zip

62220

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021