SHAW WENDI FORTUCHANG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036123438

License Status

NOT RENEWED

Business

Title

First Name

SHAW

Middle

WENDI

Last Name

FORTUCHANG

Business Name

SHAW WENDI FORTUCHANG MD

Original Issue Date

05/14/2009

Effective Date

06/01/2011

Expiration Date

07/31/2014

City

FAYETTEVILLE

State

Zip

30214

County

GEORGIA

Ever Disciplined

LastModifiedDate

11/17/2014