DAVID BRADFIELD FULLER DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125028348

License Status

EXPIRED

Business

First Name

DAVID BRADFIELD

Last Name

FULLER

Suffix

Business Name

DAVID BRADFIELD FULLER DO

Original Issue Date

05/27/1992

Effective Date

05/27/1992

Expiration Date

06/30/1995

City

CHICAGO

State

Zip

60615

County

COOK

Specialty/Qualifier

General Practice

Ever Disciplined

LastModifiedDate

09/22/2006