M MICHAEL FORUTAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036051102

License Status

NOT RENEWED

Business

First Name

M MICHAEL

Last Name

FORUTAN

Suffix

Business Name

M MICHAEL FORUTAN MD

Original Issue Date

06/24/1975

Effective Date

04/12/2017

Expiration Date

09/30/2020

City

LISLE

State

Zip

60532

County

DUPAGE

Ever Disciplined

LastModifiedDate

01/14/2021