LISA M FORTMAN Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036083565

License Status

ACTIVE

Business

First Name

LISA

Middle

Last Name

FORTMAN

Business Name

LISA M FORTMAN

Original Issue Date

10/02/1991

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

HINSDALE

State

Zip

60521

County

DUPAGE

Ever Disciplined

LastModifiedDate

04/06/2023