BRIAN C FULLER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036144916

License Status

NOT RENEWED

Business

Title

First Name

BRIAN

Middle

Last Name

FULLER

Business Name

BRIAN C FULLER MD

Original Issue Date

01/09/2018

Effective Date

01/09/2018

Expiration Date

09/30/2020

City

COLORADO SPRINGS

State

Zip

80906

Ever Disciplined

LastModifiedDate

01/14/2021