ELLIOTT MCKINLEY FOURTE MD Medical Doctor License verification

ELLIOTT MCKINLEY FOURTE MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

First Name

ELLIOTT

Middle

MCKINLEY

Last Name

FOURTE

Suffix

Business Name

ELLIOTT MCKINLEY FOURTE MD

Original Issue Date

10/24/2006

Effective Date

08/18/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60621

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014

Case Number

2013007235

Action

Revocation

Discipline Start Date

09/27/2013

Discipline Reason

following a surrender of his DEA registration for cause.