ERIC BRADLEY FULLER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058032

License Status

CANCELLED

Business

Title

First Name

ERIC

Middle

BRADLEY

Last Name

FULLER

Business Name

ERIC BRADLEY FULLER MD

Original Issue Date

06/23/2010

Effective Date

06/23/2010

Expiration Date

06/22/2013

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

04/12/2010