BRIAN C FORT MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

ACTIVE

Business

Title

First Name

BRIAN

Middle

Last Name

FORT

Business Name

BRIAN C FORT MD

Original Issue Date

03/04/2014

Effective Date

04/12/2023

Expiration Date

07/31/2026

City

WINFIELD

State

Zip

60190

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2023