TYLER JORDAN FULKS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036153714

License Status

ACTIVE

Business

Title

First Name

TYLER

Middle

JORDAN

Last Name

FULKS

Business Name

TYLER JORDAN FULKS MD

Original Issue Date

07/14/2020

Effective Date

05/05/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/05/2023