DARRYL L FORTSON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125022642

License Status

EXPIRED

Business

First Name

DARRYL L

Last Name

FORTSON

Suffix

Business Name

DARRYL L FORTSON MD

Original Issue Date

06/04/1988

Effective Date

06/04/1988

Expiration Date

06/24/1992

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006