PAUL J FORTIER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

First Name

PAUL J

Last Name

FORTIER

Suffix

Business Name

PAUL J FORTIER MD

Original Issue Date

02/05/1991

Effective Date

02/05/1991

Expiration Date

07/31/1996

City

GALESBURG

State

Zip

61401

County

KNOX

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006