DARRELL LEE FORT MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036090339

License Status

INACTIVE

Business

First Name

DARRELL LEE

Last Name

FORT

Suffix

Business Name

DARRELL LEE FORT MD

Original Issue Date

03/13/1995

Effective Date

03/13/1995

Expiration Date

07/31/1999

City

PADUCAH

State

Zip

42002

County

KENTUCKY

Ever Disciplined

LastModifiedDate

03/06/2007