KRISTINE FORTIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036126454

License Status

NOT RENEWED

Business

First Name

KRISTINE

Last Name

FORTIN

Suffix

Business Name

KRISTINE FORTIN MD

Original Issue Date

08/10/2010

Effective Date

07/15/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017