JANELL F FULLER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036104994

License Status

NOT RENEWED

Business

First Name

JANELL

Middle

Last Name

FULLER

Business Name

JANELL F FULLER

Original Issue Date

06/19/2001

Effective Date

06/19/2001

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60613

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006