ELLIOTT MCKINLEY FOURTE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036117052

License Status

NOT RENEWED

Business

First Name

ELLIOTT

Middle

MCKINLEY

Last Name

FOURTE

Suffix

Business Name

ELLIOTT MCKINLEY FOURTE MD

Original Issue Date

10/13/2006

Effective Date

08/18/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60615

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014

Case Number

2013007235

Action

Suspension

Discipline Start Date

09/27/2013

Discipline Reason

following a surrender of his DEA registration for cause.