TRAVIS STEVEN FULK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125080597

License Status

EXPIRED

Business

Title

First Name

TRAVIS

Middle

STEVEN

Last Name

FULK

Business Name

TRAVIS STEVEN FULK MD

Original Issue Date

06/26/2022

Effective Date

06/26/2022

Expiration Date

06/25/2025

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

11/03/2025