BENJAMIN R FORTSON - Podiatrist License in Illinois | # 135001137

BENJAMIN R FORTSON

Business Entity

EXPIRED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135001137

License Status

EXPIRED

Business

N

First Name

BENJAMIN

Middle

R

Last Name

FORTSON

Business Name

BENJAMIN R FORTSON

Original Issue Date

06/15/2021

Effective Date

07/01/2021

Expiration Date

06/30/2024

State

IL

Ever Disciplined

N

LastModifiedDate

01/08/2025