GLEN T FORTIER MD - Medical Doctor License in Indiana | # 036069473

GLEN T FORTIER MD

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036069473

License Status

INACTIVE

Business

N

First Name

GLEN T

Last Name

FORTIER

Suffix

MD

Business Name

GLEN T FORTIER MD

Original Issue Date

09/18/1984

Effective Date

09/18/1984

Expiration Date

07/31/1987

State

IN

Ever Disciplined

N

LastModifiedDate

09/20/2006