MARTIN GERALD FORTIER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

NOT RENEWED

Business

First Name

MARTIN GERALD

Last Name

FORTIER

Suffix

Business Name

MARTIN GERALD FORTIER MD

Original Issue Date

11/02/1981

Effective Date

04/12/2017

Expiration Date

09/30/2020

City

FOREST PARK

State

Zip

60130

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021