EARL S FORD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

NOT RENEWED

Business

First Name

EARL S

Last Name

FORD

Suffix

Business Name

EARL S FORD MD

Original Issue Date

01/15/1986

Effective Date

01/15/1986

Expiration Date

07/31/1990

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011