LA MAR R FORD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

NOT RENEWED

Business

First Name

LA MAR R

Last Name

FORD

Suffix

Business Name

LA MAR R FORD MD

Original Issue Date

11/03/1983

Effective Date

11/03/1983

Expiration Date

07/31/1993

City

INDIANAPOLIS

State

Zip

46208

County

INDIANA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006