ELLIOTT MCKINLEY FOURTE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125043877

License Status

EXPIRED

Business

First Name

ELLIOTT

Middle

MCKINLEY

Last Name

FOURTE

Suffix

Business Name

ELLIOTT MCKINLEY FOURTE MD

Original Issue Date

04/01/2002

Effective Date

04/01/2002

Expiration Date

06/03/2005

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006