THOMAS EDWARD FORD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

NOT RENEWED

Business

First Name

THOMAS EDWARD

Last Name

FORD

Suffix

Business Name

THOMAS EDWARD FORD MD

Original Issue Date

09/16/1981

Effective Date

09/16/1981

Expiration Date

07/31/1990

City

MISHAWAKA

State

Zip

46544

County

INDIANA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006