JOHN BRADLEY FORTUNE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036105683

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

BRADLEY

Last Name

FORTUNE

Business Name

JOHN BRADLEY FORTUNE

Original Issue Date

10/04/2001

Effective Date

10/04/2001

Expiration Date

07/31/2005

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/23/2009