DOUGLAS L FULK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125030092

License Status

EXPIRED

Business

First Name

DOUGLAS

Middle

Last Name

FULK

Suffix

Business Name

DOUGLAS L FULK MD

Original Issue Date

06/03/1993

Effective Date

06/03/1993

Expiration Date

06/30/1996

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/22/2006