License holder summary

Darryl Lewis Fortson is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Darryl Lewis Fortson is 1950 45th Ave. Suite# 100, Munster IN 46321-3917. This licensed professional license is current. The license was granted 08/28/1989 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Darryl Lewis Fortson
Controlled Substance Registration - Physician
License number
01037803B
Date granted
08/28/1989
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
1950 45th Ave. Suite# 100, Munster IN 46321-3917
indianalicensing.org
ID 5900070
LAST UPDATED 2024-04-20 10:02:07 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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