CLAUDE JEAN FORTIN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****83

License Status

ACTIVE

Business

First Name

CLAUDE JEAN

Last Name

FORTIN

Suffix

Business Name

CLAUDE JEAN FORTIN MD

Original Issue Date

08/29/1983

Effective Date

07/06/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/06/2023