DARRYL L FORTSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036083540

License Status

NOT RENEWED

Business

First Name

DARRYL L

Last Name

FORTSON

Suffix

Business Name

DARRYL L FORTSON MD

Original Issue Date

09/26/1991

Effective Date

05/06/2009

Expiration Date

07/31/2011

City

MUNSTER

State

Zip

46321

County

INDIANA

Ever Disciplined

LastModifiedDate

01/29/2015