ALEX EDWARD FULTZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036161016

License Status

NOT RENEWED

Business

Title

First Name

ALEX

Middle

EDWARD

Last Name

FULTZ

Business Name

ALEX EDWARD FULTZ MD

Original Issue Date

06/24/2022

Effective Date

06/24/2022

Expiration Date

07/31/2023

City

MAYWOOD

State

Zip

60153

County

COOK

Ever Disciplined

LastModifiedDate

11/30/2023