SHAW WENDI FORTUCHANG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

Title

First Name

SHAW

Middle

WENDI

Last Name

FORTUCHANG

Business Name

SHAW WENDI FORTUCHANG MD

Original Issue Date

08/10/2009

Effective Date

06/01/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014