JEFFREY F FULLENKAMP DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036076753

License Status

NOT RENEWED

Business

First Name

JEFFREY F

Last Name

FULLENKAMP

Suffix

Business Name

JEFFREY F FULLENKAMP DO

Original Issue Date

03/16/1988

Effective Date

08/04/2020

Expiration Date

07/31/2023

City

NICEVILLE

State

Zip

32578

County

JO DAVIESS

Ever Disciplined

LastModifiedDate

11/30/2023