CHARLES D FORD MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036072043

License Status

INACTIVE

Business

First Name

CHARLES D

Last Name

FORD

Suffix

Business Name

CHARLES D FORD MD

Original Issue Date

11/22/1985

Effective Date

11/22/1985

Expiration Date

07/31/1987

City

CHEYENNE

State

Zip

82009

County

WYOMING

Ever Disciplined

LastModifiedDate

09/20/2006