EDWARD G FORTIER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

NOT RENEWED

Business

First Name

EDWARD G

Last Name

FORTIER

Suffix

Business Name

EDWARD G FORTIER MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1987

City

LOMBARD

State

Zip

60148

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/24/2007

Case Number

1984000646

Action

Revocation

Discipline Start Date

08/12/1986