SAMANTHA BROOKE MACKAY-FORTON DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125082838

License Status

ACTIVE

Business

Title

First Name

SAMANTHA

Middle

BROOKE

Last Name

MACKAY-FORTON

Business Name

SAMANTHA BROOKE MACKAY-FORTON DO

Original Issue Date

06/25/2023

Effective Date

06/25/2023

Expiration Date

06/24/2026

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

06/13/2023