BENJAMIN R FORTSON Podiatrist License verification

Business Entity

EXPIRED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135001137

License Status

EXPIRED

Business

First Name

BENJAMIN

Middle

Last Name

FORTSON

Business Name

BENJAMIN R FORTSON

Original Issue Date

06/15/2021

Effective Date

07/01/2021

Expiration Date

06/30/2024

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

01/08/2025