BRETT ALLISON FULKS Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****96

License Status

ACTIVE

Business

First Name

BRETT

Middle

ALLISON

Last Name

FULKS

Business Name

BRETT ALLISON FULKS

Original Issue Date

05/21/2020

Effective Date

03/20/2024

Expiration Date

05/31/2026

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026